Abstracts

Rationale: There is growing evidence that idiopathic generalised epilepsies (IGE) are not relatively benign conditions. Reductions in cognitive function, increased prevalence of psychiatric disorders and poorer psychosocial outcomes have been reported. Studies of adult IGE patients report 13-30% prevalence of diagnosed comorbid mood disorders in IGE (Akanuma et al., 2008; Cutting et al., 2001). However the prevalence of undiagnosed and therefore untreated psychopathology symptoms in adults with IGE has not been well studied. This study seeks to assess the burden of psychopathology symptoms in a representative sample of people with IGE using self- and informant-report screening questionnaires. Methods: We recruited an outpatient sample of 56 patients with EEG-confirmed IGE. 47 adult patients completed the Adult Self-Report form of the Achenbach System of Empirically Based Assessment (9 patients were children). For a subset of n=31, a partner, parent or close friend also completed the corresponding Adult Behavior Checklist. Recruitment is ongoing and anticipated to be n=100 by December 2014. The DSM-oriented scales of the Achenbach System are consistent with DSM-IV diagnostic criteria for depression, anxiety, somatization, avoidant personality, attention deficit/hyperactivity and antisocial personality. Responses endorsing symptoms in the borderline-clinical (T>=65-69) or clinical range (T>=70) were considered elevated, as specified by ASEBA Manual. Frequencies of elevated symptoms in our IGE sample were contrasted with 5% prevalence in the normative sample. Results: IGE patients were aged 13-58 years (mean: 29.4, SD: 11.2). Approximately one-third of respondents endorsed elevated depressive symptoms, with a high degree of concordance between self- and informant-reports (29.8% and 32.3% respectively). 21.3% of patients endorsed elevated symptoms of anxiety, however this was recognized by less than half of their corresponding informants (9.7% of the total sample). Avoidant personality and attention deficit problems were also highly rated by patients (23.4% and 25.3% respectively), with antisocial problems rated less frequently (10.6%). 38.3% of patients endorsed elevated symptoms in two or more areas. Figure 1 shows mean self- and informant-report patient scores on all DSM-oriented scales were above the normative sample average (T=50 by definition). Anxiety symptoms were rated significantly higher by patients than their families. Conclusions: These results indicate a high prevalence of unrecognised psychological health needs in patients with IGE, affecting over half of our sample. Depressive symptoms were most common, but also included anxiety, avoidant personality and attention deficit problems. In contrast to work in children and youth, our results suggest that patients may have more insight into these problems than their families (Huberty et al., 2000). The results warrant replication in larger samples and highlight the need for routine screening of common psychiatric symptoms. Together with emerging evidence regarding generalised cognitive deficits, this study illustrates that the IGEs may not be relatively benign.