Abstracts

Rationale: Clinically significant depressive symptoms are found in 10-30% of youth with epilepsy; prevalence rates for suicidal ideation are greater than 25%. Even though depression in youth with epilepsy is common, it is often an undiagnosed disorder. Therefore, proper assessment and an early identification are essential to initiate treatment and minimize the risk for poor outcomes. The current study examined the predictive utility of the Neurological Disorders Depression Inventory for Youth (NDDI-E-Y), a recently developed depression screening scale specific for youth with epilepsy, in explaining variance in overall depressive symptoms and specific symptom clusters on the gold standard Children’s Depression Inventory-2 (CDI-2).Methods: Participants were 99 youth ages 12-17, diagnosed with epilepsy (ICD 9 codes 345.0 through 345.9x), had IQ>85, and were able to self-report. During a routine epilepsy visit, youth completed self-report measures of depression, including the NDDI-E-Y, the CDI-2, and the NeuroQoL. The NDDI-E-Y has demonstrated preliminary reliability and validity and was recently revised to include 12 items. The CDI-2 is a 28-item scale of depressive symptoms, divided into 4 different subscales, i.e., interpersonal problems (IP), negative mood (NM), ineffectiveness (IF), negative self-esteem (NS), which comprise two scales [emotional problems (EP), functional problems (FP)] and a total score. The Depression Short Form of the Pediatric NeuroQoL is an 8-item measure of depression validated in youth with neurological disorders.Results: Overall, the NDDIE-Y and the NeuroQoL significantly predicted the CDI-2 total scale, and subscale scores. In individual models, the NDDIE-Y total score explained 48.4% of variance in the CDI total score, 37% of variance in IP, 29.4% of variance in NM, 43.9% of variance in IF, 38.9% of variance in NS, 40.6% of variance in EP, and 47% of variance in FP. The NeuroQoL explained 37.6% of variation in the CDI-2 total score, 35.7% of variation in IP, 16.3% of variation in NM, 29.3% of variation in IF, 30% of variation in NS, 24.6% of variation in EP, and 35.6 % of variation in FP. All results had a p-value of <0.0001.Conclusions: Our aim was to investigate whether the NDDI-E-Y would better predict the overall depression or specific symptom clusters of depression and whether the NDDI-E-Y or the NeuroQol predicted more variance in the CDI-2. The NDDI-E-Y accounts for more variance in the total score and subscales of the CDI-2 compared to the NeuroQol. Interestingly, the NDDI-E-Y and NeuroQol accounted for the lowest amount of variance for negative mood. This suggests that the NDDI-E-Y does not tap into negative mood but does evaluate feelings of ineffectiveness. Relying solely on total depression scores may not provide an accurate picture of depression in youth with epilepsy. This study was funded by the William Henkin Foundation.