Depression and Suicidality Among Hispanics with Epilepsy: Findings from the Managing Epilepsy Well (MEW) Network Integrated Database
Abstract number :
3.378
Submission category :
16. Epidemiology
Year :
2021
Submission ID :
1826065
Source :
www.aesnet.org
Presentation date :
12/6/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:51 AM
Authors :
Susanna O'Kula, MD - SUNY Downstate Health Sciences University; Farren Briggs - Department of Population and Quantitative Health Sciences, School of Medicine, - Case Western Reserve University; Brittany Brownrigg - Department of Psychiatry - University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine; Kaylee Sarna - The Neurological and Behavioral Outcomes Center, Pyschiatry - Case Western School of Medicine; Omar Rosales - Houston School of Public Health - University of Texas Health Science Center; Ross Shegog - Houston School of Public Health - University of Texas Health Science Center; Robert Fraser - Rehabilitation Medicine/Epilepsy Center - University of Washington; Erica Johnson - Rehabilitation Medicine/Epilepsy Center - University of Washington; Rakale Quarrells - Department of Community Health and Preventive Medicine - Morehouse School of Medicine; Daniel Friedman - Department of Neurology - New York University Langone Health; Martha Sajatovic - Case Western Reserve University School of Medicine and Neurological and Behavioral Outcomes Center - University Hospitals Cleveland Medical Center; Tanya Spruill - Department of Population Health - New York University School of Medicine
Rationale: While psychiatric disorders are higher among people with epilepsy (PWE), depression and suicidal ideation (SI) among Hispanics with epilepsy remain understudied, representing critical epidemiologic gaps with clinical implications. We examined the prevalence and correlates of depression and SI among Hispanic PWE who participated in epilepsy self-management studies in the CDC’s Managing Epilepsy Well (MEW) Network.
Methods: This cross-sectional analysis of the MEW Network’s integrated baseline database across ten studies used the Patient Health Questionnaire-9 (PHQ-9) or Neurological Disease Depression Inventory-Epilepsy (NDDI-E) to assess for depression (PHQ ≥10, NDDI-E ≥15) and SI (≥1 PHQ-9 item 9, ≥2 NDDI-E item 4). Multilevel mixed-effects logistic regression models examined the associations between ethnicity and depression, ethnicity and SI among PWE, adjusting for likely sociodemographic and clinical factors with study site as a random effect. Secondary analyses examined predictors of depression and SI among Hispanic PWE with acculturation data (language preference, country of origin).
Results: Of the 559 participants included, 49.6% were Hispanic and 58.7% identified as female. The mean age was 42.1 (±13.0), 38.3% were married/partnered, 33.1% were employed, and 56.4% had some level of college education. Prior 30-day seizure frequency was available for 277 PWE: 59.6% had ≥1 seizure in the past month.
Depression was endorsed by 38.1% of participants (32.5% of Hispanics) and SI was endorsed by 18.4% (16.3% of Hispanics). After adjusting for sociodemographic factors and health status, Hispanic PWE had a 44% lower prevalence of depression (OR=0.56, CI 0.37-0.84, p=0.0056) compared to non-Hispanics. Ethnicity was not significantly associated with SI (OR=0.84, CI 0.45-1.58, p=0.59).
Acculturation measures were available for Hispanic PWE in a subset of studies from NYC and the Southwest (n=256). Spanish was the preferred language for 62.9% of Hispanic participants and 46.1% were foreign-born, Table 1. Overall, Mexico was the most common non-U.S. country of origin (47.5%) but this varied substantially by site. In multilevel models, those with Spanish language preference were less likely to be depressed (OR=0.43, CI 0.19-0.97, p=0.041), while those with fair/poor health status had a four-fold higher depression prevalence (OR=4.44, CI 1.50-13.18, p=0.0071), Table 2. Among those with 30-day seizure frequency (n=162), ≥1 monthly seizure was independently associated with higher depression prevalence (OR=3.11, CI 1.29-7.45, p=0.01). Being foreign-born was not associated with depression or SI prevalence.
Conclusions: In a large, geographically diverse sample of PWE from the MEW Network, depression rates were significantly lower in Hispanics compared to non-Hispanics. Spanish language preference was associated with a lower prevalence of depression among Hispanic PWE. Both seizure frequency and poor health status were independent predictors of depression in Hispanic PWE, with similar, non-significant trends for suicidal ideation. Acculturation data should be included in future studies to improve understanding of depression and SI risk and optimize interventions for Hispanic PWE.
Funding: Please list any funding that was received in support of this abstract.: None.
Epidemiology