Abstracts

This abstract has been invited to present during the Broadening Representation Inclusion and Diversity by Growing Equity (BRIDGE) poster session

Rationale: Depression and anxiety are common comorbid psychiatric conditions affecting up to 50% of people with epilepsy (PWE). Non-Hispanic Blacks reporting serious psychological distress are less likely to receive treatment than non-Hispanic whites. Past studies found that Blacks’ attitudes and beliefs regarding mental illness stem from mistrust of mental health treatment and providers, and that they view depression as a weakness. Project UPLIFT (Using Practice and Learning to Increase Favorable Thoughts), a mindfulness-based cognitive therapy intervention, provides access to distance-delivered mental health self-management skills training; it does not interfere with medication management and has been shown to reduce depressive symptoms over the program’s eight one-hour weekly telephone sessions. However, prior studies of UPLIFT included samples with less than 5% Black PWE. The purpose of this study was to assess the efficacy of UPLIFT in reducing depressive and anxiety symptoms in Black PWE._x000D_
Methods: Depression and anxiety symptoms were measured at baseline and post-intervention using the Beck Depression Inventory (BDI) to measure depression symptoms and the Generalized Anxiety Disorder for anxiety symptoms. A total of 82 participants were randomized into the UPLIFT intervention or waitlist control groups (57 women and 25 men). Participants had to self-identify as Black/African American, be English-speaking, age 18 or older, mentally stable as assessed by the T-MMSE and diagnosed with epilepsy at least 3 months prior. Descriptive and paired t-test analyses were performed to examine study outcomes._x000D_
Results: Participants ranged in age from 19-64 years; the average age of epilepsy diagnosis was 25 years. Study participants’ mean depression score at baseline was 11.03 (SD=9.80) and 8.9 (SD=8.76) at post-intervention. Depression significantly decreased at post-intervention (p=0.03). The mean anxiety score was 7.34 (SD=5.78)at baseline and 6.74 (SD=5.36) at post-intervention and did not significantly decrease at post-intervention (p=0.35). At baseline, 67 of the 82 respondents (81.7%) had only minimal or mild depression, according to the BDI. Likewise, 58 of the 82 respondents (70.7%) had minimal or mild anxiety according to the GAD. Thus, most participants did not endorse distress at the start of the study. Given the prevalence of mild and minimal depression and anxiety baseline scores, we expected to experience a floor effect. Therefore, subsequent analyses were conducted excluding those with mild depressive symptoms. Depression was significantly reduced post-intervention (baseline: 22.79; post-intervention: 16.47, p=0.00). Similarly, after excluding those with mild anxiety symptoms, anxiety was significantly reduced post-intervention (baseline: 11.05; post-intervention: 8.24, p=0.01)._x000D_
Conclusions: This study supports the existing evidence base of Project UPLIFT for reducing depression in PWE and adds evidence that it also reduces symptoms of anxiety. In summary, Project UPLIFT was efficacious in reducing symptoms of moderate and severe depression and anxiety in Black PWE.

Funding: CDC #U48DP005042