Abstracts

Rationale: Symptoms of Attention Deficit Disorder (ADD and ADHD) have been well-described in pediatric epilepsy cases(1) but little is known about rates and impact of ADD/ADHD in adults with epilepsy. Methods: An 11-item screening survey to 340,000 households in 2008 obtained self-reported information on epilepsy and other conditions from a representative sample of 172,959 adults aged 18+(2). A 2009 follow-up postal survey to persons with epilepsy included the 6-item Adult ADHD Self-Report Scale (ASRS) to identify individuals at risk for Attention Deficit Disorder (ADHD). Validated measures assessing quality of life (QOLIE-10, QLESQ), social functioning (Sheehan Disability Scale, SDS), depression (PHQ-9) and anxiety (GAD-7) were included as were sociodemographic and employment status questions. Chi-square was used to assess sociodemographics differences between those at risk for ADHD (ASRS+) and those not at risk (ASRS-). Linear regression models (controlling for sociodemographics) were used to contrast ASRS+ vs. ASRS- cases on quality of life and social functioning measures. Logistic regression was used to assess differences in rates of work related disability. Depression and anxiety frequently co-occurred with ADHD risk and were included as covariates in further modeling to assess their influence on ASRS group differences. Beta (β) or Odds Ratios (OR) and 95% confidence intervals (CI) were calculated for each model. Results: N=1451 individuals reported doctor-diagnosed seizure or epilepsy and were currently using prescription seizure medication. The analysis included n=1361 with complete ASRS data. N=251 (18.4%) were ASRS+ and more likely to be younger (p=.045), have lower incomes (p<.001) and live rurally (p=.004). No gender difference was observed (p=.301). Compared with ASRS- cases, ASRS+ cases had higher/worse QOLIE scores (β 8.44, CI 7.42-9.45, p=.000), lower QLESQ social (β -0.21, CI -0.24- -0.19, p=.000), QLESQ physical (β -0.19, CI -0.22- -0.17, p=.000) and SDS global scores (β 9.82, CI 8.52-11.13, p=.000). They were also more likely to be on work related disability (OR 2.59 CI 1.89-3.53, p=.000). PHQ-9 and GAD-7 scores above clinical cut-point occurred in 23.5% and 25.7% of ASRS+ cases respectively, and in 2.0% and 5.7% of ASRS- cases. Regression results were attenuated but remained significant when PHQ-9 and GAD-7 scale scores were included as model covariates. Conclusions: Attention Deficit Disorder symptoms are common in adults with epilepsy and have an adverse impact upon quality of life and psychosocial functioning, independent of comorbid depression and anxiety. References: 1. Hamoda et al. Expert Rev Neurother. 9(12): 1747-1754 2. Ottman et al. Epilepsia, 52(2):308-315