Abstracts

Rationale: Depression and anxiety are common symptoms reported by patients with epilepsy and have a negative impact on health related quality of life (HRQOL). Despite this recognition, psychiatric disease remains under-recognized and in patients with epilepsy. Many hypotheses have been proposed to explain the relationship between emotional dysfunction and epilepsy, though this remains poorly understood. Although increased prevalence of depression and anxiety has been widely established in women in the general population, gender differences have not been extensively examined in patients with epilepsy. This study was designed to identify gender differences in the prevalence of depression and anxiety in people with epilepsy and to examine the impact of these variables on health related quality of life.Methods: 119 consecutive patients in the University of Maryland Epilepsy Outpatient Center and Inpatient Epilepsy Monitoring Unit (EMU) completed Beck Depression Inventory-II (BDI-II®), Beck Anxiety Inventory (BAI®), and Quality of Life in Epilepsy (QOLIE-31) measures between December, 2005 and May, 2007. Patients who completed these questionnaires in the Epilepsy Monitoring Unit (EMU) did so on the day of admission before their medications were changed and prior to any seizure activity. Scores were calculated for each inventory and means were compared using standard t-test calculations. Regression analysis was used for assessment of the relationship between gender, anxiety, depression and HRQOL.Results: Mean depression (BDI-II) scores were 11.76 for men and 13.96 for women with epilepsy. This difference was not statistically significant (p=0.27, CI -1.72 to 6.11). There was also no statistically significant difference in mean anxiety (BAI) scores between men (9.88) and women (11.47), (p=0.44, CI -2.44 to 5.64), though both comparisons revealed a trend towards greater depression and anxiety in women. Overall HRQOL T scores were calculated for each group and were lower in women (59.37) than men (63.60), though not significant (p=0.26, CI -11.69 to 3.22). There was also no significant difference in HRQOL scores between men and women with the same reported levels of depression or anxiety. However, both the BDI and BAI were strongly predictive of HRQOL (p<0.001) in all patients.Conclusions: Although it was predicted that women with epilepsy would have significantly higher rates of depression and anxiety, this hypothesis was not strongly supported by this study. These data showed trends towards higher reported symptoms of depression and anxiety and worsened HRQOL in women, though did not reach statistical significance. This may be partially explained by relatively low number and heterogeneous patient population in the study, though may suggest alternate hypotheses for this disparity. The predictive value of the BDI and BAI of HRQOL was strongly supported in this analysis, confirming the role of depression and anxiety in quality of life in this patient population.