Abstracts

Rationale: A recent article by Burneo (2004) mentioned the necessity to consider ethnic differences in epilepsy clinical trials. Many trials either do not mention the ethnicity of patients or do not elaborate on whether there are ethnic differences upon statistical analysis that could potentially confound study results. The purpose of the current study was to explore the ethnic differences on self-reported psychological distress, in an epilepsy patient sample. The PAI, a questionnaire commonly used to assess emotional and psychiatric symptoms was used as a marker of psychological distress. Methods: Retrospective chart review of admissions to Yale’s Epilepsy Monitoring Unit was conducted. Patients completed the PAI during inpatient VEEG. The sample consisted of 132 patients with varying types of epilepsy. There were three ethnic groups represented: African-American (AA), Caucasian (C), and Latino (L). Approximately 12% of the sample did not report ethnicity and were therefore excluded from the analysis. Of the remaining 116 patients, approximately 11.2 % were AA, 85.3% C, and 3.4% L. The majority of the sample was female (60%). Mean age of the group was 38 years (range of 17 to 76. Almost half of the patients had an education level of 12th grade or lower (48.5%). The other portion had a college/graduate level education (51.5%). Results: The PAI consists of a number of global scales each of which encompasses a number of subscales. There were no elevations on the global scales; there were a number of subscale elevations (see Table 1). One-way ANOVA indicated significant differences between ethnic groups on the physiological-anxiety and -depression subscales. There were significant differences on the phobias-anxiety, mania-activity level, negative relationships-borderline features, and both the hypervigilance and persecution subscales of the Paranoia scale. L showed the highest elevations on the physiological-anxiety and -depression subscales, and AA on the paranoia, mania, anxiety-related, and negative relationships subscales. Conclusions: There were different elevation patterns of psychiatric symptoms in ethnic minorities with epilepsy. Specifically, there were significant differences in symptoms of depression, anxiety, mania, paranoia, and borderline features on the PAI. These higher elevations suggest that ethnicity may play a role in the likelihood of certain psychiatric symptoms among epilepsy patients. AA showed greater elevations in paranoia and anxiety-related symptoms, which may be explained by historical theories of perceived racism or social inequality (Combs, 2006). This may also be related to distrust of the health system itself. L showed marked elevations on physiological symptoms of depression and anxiety. They may be more comfortable endorsing the physiological symptoms rather than the psychological or cognitive features of a psychiatric illness because of a cultural taboo shaming open discussion of problems and emotions (Wing, Sue, & Sue, 1990). Future research should key in to ethnic differences, so psychological treatment can be more directed to the ethnic groups’ unique needs.