Abstracts

Rationale: Epilepsy is a common neurological disorder of childhood, most recent prevalence estimated at 1% in the United States, and is associated with a number of comorbid conditions, including depression (Russ, Larson, & Halfon, 2012; Zach & Kobau, 2017). Among adolescents with epilepsy 10-30% have clinical depression (Caplan et al., 2005; Russ et al., 2012). Depression in this population is a complex issue impacted by patients’ underlying neurologic disorder, social stigma associated with epilepsy, as well as impact of anti-epileptic drugs (AEDs) on suicidal ideation and mood. Depression associated symptoms and suicidal ideation may occur at any time during the disease course and patients should undergo routine assessments, even if previous screening results were negative (Guilfoyle, Monahan, Wesolowski, & Modi, 2015). Despite the known association of depression and epilepsy, the routine assessment for depressive symptoms does not occur in the outpatient clinical setting. Therefore, the implementation of a standardized depression screening tool will provide screening for depression symptoms in patients presenting for routine epilepsy care in the neurology clinic. Methods: Patients, 12-17 years, with a diagnosis of epilepsy, presenting for routine epilepsy care will be enrolled for screening.  Patients must have a current diagnosis of epilepsy, as defined by the International League Against Epilepsy (ILAE), be English speaking/reading and without severe cognitive disability. Patients meeting inclusion criteria will complete the NDDI-E-Y, a free, brief, and validated tool that was designed for implementation in this population (Wagner et al., 2016; Wagner et al., 2013). Demographics including gender and selection of age range 12-14 or 15-17 will be included in the results. No patient identifiers will be collected. Scores greater than or equal to 32 are associated with symptoms of depression (Wagner et al., 2016). For those with scores greater than or equal to 32, social work will complete an assessment and provide the patient with appropriate mental health referrals.  Patients and families will also receive an educational sheet outlining the results of the screen, the contact information for the clinic social worker, mental health resources, and the importance of treating depression. Patients with NDDI-E-Y scores less than 32 will receive information about the screening completed and risk for depression throughout the course of the disease. It will be important to communicate with the child and family that while someone may have had a low score depression can develop at any time.  Results: The patient screening, NDDI-E-Y, and documentation of social work referral will be completed via a REDCap survey and will not include any patient identifiers. Nursing surveys will be completed within REDCap, and collected following education, with post survey completed in the week following 1-month pilot implementation. Given that no standard screening currently occurs, pre-implementation rate of zero will be assumed. This data will then transferred to IBM SPSS Statistics for analysis and manipulation. Conclusions: Depression is a known comorbid condition in epilepsy that is associated with increased risk for suicide and impairment in quality of life.  Validated, brief, depression screening tools exist, specifically NDDI-E-Y, to assess for symptoms of depression.  Families that receive education on the importance of mental health and risk of depression have improved attitudes toward mental health. Therefore, it is vital that clinics are utilizing the available resources to assess and provide appropriate referrals and educations for youth with epilepsy.  Funding: No funding was received in support of this research or abstract.