Abstracts

Co-morbid depression in persons with epilepsy (PWE) is common; reported estimates of prevalence range from 20 - 50%. Less is known about the impact of depression on healthcare resource use in PWE. The objective of this study was to determine the relationship between depression severity and healthcare resource use among PWE.
1903 PWE were pre-identified from large epidemiology database of epilepsy and other chronic conditions and mailed a follow-up survey containing questions regarding co-morbid health conditions, physician consulting, hospitalization, social services use, and health insurance. Past-week depression was confirmed using Centers for Epidemiological Studies Depression scale (CES-D). Lower income was found among PWE with depression (p[lt]0.0001); income was controlled for in the analysis.
775 PWE returned surveys (41% response rate). Major depression was seen in 172 (22%), moderate depression in 75 (10%), and no depression in 447 (58%). Depressed PWE were significantly more likely to report additional co-morbid psychiatric conditions (anxiety, bipolar disorder) as well as other health problems (arthritis, migraine, asthma, diabetes, hypertension) versus PWE without depression. Depressed PWE were more likely to have consulted a healthcare professional or a psychiatrist versus PWE without depression. Only 34% of PWE with major depression and 17% of PWE with moderate depression reported past psychiatric consult. Depressed PWE were significantly more likely to report hospitalization, use of social services, Medicaid, or other public assistance.
The prevalence of depression in PWE in this sample is consistent with previously reported estimates. The current study also found that depression among PWE is associated with greater use of healthcare resources compared to PWE without depression. Despite the significant co-morbidity of depression in epilepsy, only a minority of depressed PWE have ever consulted a psychiatrist.
[Supported by: GlaxoSmithKline]