Abstracts

Rationale: Depression is common in patients with epilepsy and the strongest predictor of poor quality of life. Depression in epilepsy is under-recognized. Few studies have assessed the association of uncontrolled seizures with depression. We used the neurological disorders depression inventory for epilepsy (NDDI-E), a validated six-item self-report questionnaire, at a tertiary epilepsy center to assess the relationship between depression, seizure control, and antiepileptic drug (AED) usage. Methods: NDDI-E scores, seizure frequency, and AED usage were recorded in 349 patients. Robust linear regression and logistic regression were used for statistical analysis. Results: 18.34% of patients had NDDI-E scores >15, consistent with major depression. NDDI-E scores were associated with seizure control (p<0.001). NDDI-E scores >15 were more prevalent in patients with seizures in the past month compared with seizure-free patients (p=0.014). The odds ratio (OR) was 2.4(95% CI=0.927-6.212) for patients reporting 1 seizure and 2.387(95% CI=1.285-4.434) for those reporting >1 seizure. NDDI-E scores >15 were more prevalent in patients with seizures in the past 6 months compared with seizure-free patients (p=0.037). The OR was 2.804(95% CI=1.014-7.757) for patients reporting 1 seizure and 2.308(95% CI=1.15-4.631) for those reporting >1 seizure. There was an association between the number of AEDs and NDDI-E scores (p=0.0005). The OR for NDDI-E scores >15 in patients taking more than 1 AED relative to patients taking one AED was 2.48(95% CI=1.365 - 4.508). Conclusions: Major depression is associated with uncontrolled seizures, with a greater than 2-fold increase relative to patients whose seizures are controlled.