Abstracts

Rationale: A sizeable proportion of patients with epilepsy also suffer from psychiatric co-morbidity, in particular, depression. The perception of epilepsy as a stigmatizing condition may also greatly affect depression which in turn can affect the patients’ perception of their capability to manage their own epilepsy. Hispanics form the largest minority group in the U.S. and are at higher risk for depression. Factors that influence depression among Hispanics with epilepsy should be identified, and the effect of these factors on epilepsy self efficacy further explored. Methods: Preliminary results from the first 42 patients are presented here. A total of 100 adult Hispanic patients will be recruited from the University of Arizona’s epilepsy clinic to respond to questionnaires related to depression, epilepsy self efficacy, acculturation, family involvement and criticism, and perceived stigma at baseline and at three months. Results: Using the Patient Health Questionnaire (PHQ-9) to assess for depression, 36% of the patients were found to have mild to severe depression, while 64% were not depressed. When groups are compared for their epilepsy self efficacy score, as measured with the Epilepsy Self Efficacy Scale, the non-depressed group shows significantly higher mean self efficacy scores than those with depression (p< 0.02). To evaluate social support, the Interpersonal Support Evaluation List (ISEL) was utilized. Total ISEL scores (of a possible total score of 40) between the groups was also significant (p< 0.02). The ISEL has four components that measure support for appraisal, belonging, tangible support, and self esteem. Depressed patients had significantly lower scores for appraisal (p=0.04), belonging (p=0.02), and tangible support (p=0.01). Self esteem is trending low, but is not yet significant (p=0.08). No relationship between epilepsy self efficacy or depression was seen when evaluating for acculturation towards Anglo or Mexican culture. Conclusions: Depressed patients with epilepsy have significantly lower epilepsy self efficacy compared to patients with no depression. Evaluation of social support shows lower appraisal, belonging, and tangible support in the depressed group as well. Understanding the cultural effects on depression and its subsequent affect on epilepsy self efficacy may provide greater insight to treating epilepsy in this population. (Supported by a grant from the National EpiFellows Foundation).