Abstracts

Rationale: Routine and on-going assessment of psychiatric comorbidities in persons with epilepsy (PWE) has now been established as an important quality measure and is increasingly being recognized as standard of care in the field of neurology.  The purpose of the current project is to describe our experience in implementing an updated protocol of mood disorder screening and brief psychoeducational interventions for patients in our epilepsy clinic. Methods: Adult patients seen at the Minnesota Epilepsy Group (MEG) clinic for first-time or follow-up clinic visits were administered a brief, self-report screening questionnaire.  116 questionnaires were randomly selected from a 12-month time period (05/17 - 05/18).  The questionnaire included the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), a suicide question similar to the Beck Depression Inventory-II, and the Generalized Anxiety Disorder 7-item scale (GAD-7).  Patients were also asked if they were currently being treated by a psychiatrist and/or psychologist/counselor.  Clinic nursing staff scored the screening measure and took one of the following actions based on the patient’s responses: 1) no action, 2) EFA Epilepsy & Mood Disorders booklet/referral information packet provided, 3) suicide risk assessment by psychology staff, and/or 4) individual Health Coaching sessions offered. Results: 105 questionnaires met inclusion criteria for further analysis.  Mean age of the sample was 42.0 while 42% were male.  5.8% and 13.6% of the patients reported currently seeing a psychiatrist and/or psychologist, respectively.  The mean scores on the NDDI-E and GAD-7 were 10.3 (>15 suggests a depressive disorder) and 4.5 (>9 suggests an anxiety disorder).  12.4% and 18.1% met cut-off criteria for depressive and anxiety disorders, respectively.  Only 1% of the sample indicated active suicidal ideation, which required an acute suicide risk assessment.  There was a significant correlation between the NDDI-E and GAD-7 (r = .76, p < .001).  15.1% met established criteria to receive the epilepsy/mood disorders information packet, and 72 % had no action taken.  2% expressed interest in individual Health Coaching sessions. Conclusions: We demonstrate an efficient mood disorder screening/intervention protocol in a busy epilepsy clinic.  Approximately 12-18% of adult patients presenting to our clinic report significant depression or anxiety symptoms with a greater number indicating anxiety.  There is a co-incidence of depression and anxiety in PWE.  Very few exhibit active suicidal ideation/intent.  Health coaching sessions have not been shown to be of interest for PWE.  Reasons for this will be considered.  The relationship between anxiety/depression scores and participation in mental health services will be reviewed. Funding: Not applicable