Abstracts

Rationale: Previous research of depressive symptoms in parents of children with epilepsy has focused almost exclusively on mothers. The purpose of this study was to explore depressive symptoms in a sample of fathers who were the primary caregivers for their children with new-onset epilepsy. Specifically, the objectives were to examine: 1) level of depressive symptoms in the first 24 months after epilepsy diagnosis; 2) whether level of depressive symptoms changed during the 24-month follow-up; and 3) father, child, and family factors associated with depressive symptoms during this time.Methods: Data was obtained from the Health-Related Quality of Life in Childhood Epilepsy Study (HERQULES), a 24-month prospective study of children aged 4-12 years recently diagnosed with epilepsy. Data were restricted to fathers who were the primary caregivers during follow-up (n=11). Paternal (age, marital status, education, employment, depressive symptoms), child (age, sex, seizure type, epilepsy classification, duration, medication use, severity, health-related quality of life), and family (functioning, resources, demands, income) variables were examined using father and neurologist report at post-diagnosis, 12, and 24 months. Depressive symptoms in fathers were measured using the Center for Epidemiological Studies Depression Scale (CES-D). Non-parametric methods were used to examine associations of post-diagnosis variables with CES-D scores. The Friedman test was conducted to examine changes in CES-D scores over time. All hypothesis tests were two-sided with ?=0.10.Results: Fathers median CES-D scores were 11 (range 3-22) at post-diagnosis, 12 (1-20) at 12 months, and 10 (0-25) at 24 months. Using a CES-D score of ?16 as indicating clinically relevant levels of depressive symptoms, 3 (30%), 1 (10%), and 2 (18%) met this criteria at post-diagnosis, 12 and 24 months, respectively. There was no evidence to suggest that fathers CES-D scores changed significantly during the 24-month follow-up (?2=1.54, p=0.46). Among the child characteristics assessed, GASE scores were correlated with CES-D scores at 12 months (r=-0.67, p<0.05) and QOLCE scores were correlated with CES-D scores at 12 months (r=-0.74, p<0.05) and 24 months (r=-0.90, p<0.01). Fathers of children with generalized seizures had higher CES-D scores at 24 months compared to fathers of children with partial seizures (t=2.49, p<0.05). Among family characteristics, APGAR scores were correlated with CES-D scores at 12 months (r=-0.66, p<0.05) and FILE scores were correlated with CES-D scores at post-diagnosis (r=0.59, p<0.10), 12 months (r=0.64, p<0.10), and 24 months (r=0.57, p<0.10).Conclusions: This study is the first to prospectively document depression in fathers who are the primary caregivers of children with newly diagnosed epilepsy. Results were similar to other studies in the paediatric setting that focused on mothers, suggesting that gender effects may not exist for parents who are the primary caregiver for a child with epilepsy. Further research is needed to support this hypothesis.