Multivariable Models Reporting Increased Economic and Humanistic Burden Among Patients with Epilepsy Reporting Focal Onset Seizures (FOS) Experiencing Moderate-Severe Depression Symptoms
Abstract number :
2.325
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2025
Submission ID :
741
Source :
www.aesnet.org
Presentation date :
12/7/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Alvin Ong, PharmD – Xenon Pharmaceuticals Inc.
Joanne Wagner, PhD – Xenon Pharmaceuticals Inc.
Bhagyashree Oak, PhD – Trinity Life Sciences, LLC
Brittany Smith, MPH, MBA – Trinity Life Sciences, LLC
Amod Athavale, PhD, MS – Trinity Life Sciences, LLC
Cynthia Harden, MD – Xenon Pharmaceuticals Inc.
Rationale: Significant gaps remain in our understanding of how mental health can compound disease burden in people with epilepsy (PwE) reporting focal onset seizures (FOS). Previously, we reported the holistic burden experienced by PwE; given the heterogeneity of epilepsy and the potential for disease- and demographic-related characteristics to confound associations, this study aims to use multivariable regression analyses to quantify the independent relationship between depression symptoms and healthcare resource utilization (HCRU) or quality of life (QoL).
Methods: A quantitative, cross-sectional, web-enabled survey was conducted from July to September 2023 to examine the burden of illness for patients reporting FOS. Patients were recruited via patient panels or point of care physician referrals. Eligible patients were United States residents and 18-80 years old, with a physician-confirmed diagnosis of FOS for >1 year, >1 seizure per month, past/present use of >2 anti-seizure medication (ASMs), and currently receiving an ASM for >1 month. Data was collected via a custom questionnaire and validated tools, including the Patient Health Questionnaire-9 (PHQ-9), used to self-report depression-related symptom severity with higher scores indicating more severe symptoms, and the Quality of Life in Epilepsy Inventory-10 (QOLIE-10), used to self-report the impact of epilepsy on QoL with higher scores indicating better QoL. Multivariable regression analyses were conducted to assess the association between depression and QoL, inpatient visits, emergency room (ER) visits, and regimen adherence, after controlling for disease- and demographic-related covariates (e.g., seizure frequency, number of comorbidities, anxiety, age).
Results: Of the 170 patients reporting a diagnosis of FOS in the survey, the mean PHQ-9 score was 11.2 (5.2) out of 27. 63.5% (108/170) of patients had a PHQ-9 score >10, suggestive of moderate-severe depression. Individuals with moderate-severe depression had a QOLIE-10 score that was 12 points lower than those with none-mild depression, reflecting a worse QoL after adjusting for covariates. Individuals with moderate-severe depression also reported approximately 5 times more inpatient visits compared to those with none-mild depression post-adjustment for covariates. ER visits and treatment adherence were not statistically significantly different among individuals with moderate-severe vs. none-mild depression after adjusting for covariates. Directionally, patients with moderate-severe depression had approximately 1.2 times more ER visits and the odds of being adherent were 56% lower in patients with none-mild depression.
Conclusions: The results highlight the heightened burden experienced by PwE reporting FOS with self-reported moderate-severe depression. Even after controlling covariates, patients experienced significantly lower QoL and higher HCRU. This suggests that self-reported depression adds to the humanistic and economic burden, highlighting the need for increased recognition of depression symptoms in the epilepsy population.
Funding: Study supported by Xenon Pharmaceuticals Inc.
Cormorbidity (Somatic and Psychiatric)