Abstracts

Rationale: People living with Epilepsy (PLWE) experience disproportionally higher rates of psychiatric illnesses which contribute to complications and mortality. Given the stigmatizing effect of epilepsy and psychiatric illnesses, individuals with both of these conditions are doubly stigmatized. Heavy stigma burden and undertreated mental illness may explain the finding that suicide among people with epilepsy is 5 times that of the general population. However, there is a paucity of studies that have examined the demographic/clinical differences among PLWE with different types of comorbid psychiatric illnesses and their relevance to both epilepsy care and mental health care.  Methods: This analysis used baseline data from the TIME study, a randomized controlled trial testing a self-management treatment for epilepsy and psychiatric illnesses, to examine differences between PLWE with bipolar disorder (BD), schizophrenia (SZ) and major depressive disorder (MDD) (N=44). Inclusion criteria included having a DSM IV diagnosis of schizophrenia, schizoaffective disorder, BD, or chronic/recurrent MDD, confirmed with the Mini-International Neuropsychiatric Interview (MINI). Inclusion criteria also included a diagnosis of epilepsy (told by physician that they had epilepsy), >=age 18, and able to provide written consent. Demographic variables included age, race, ethnicity, gender, education level, employment, marital status, and income level. Seizure frequency was measured via a 30-day self-reported survey. Medical co-morbidities were measured with a self-reported version of the Charlson Comorbidity Index (CCI). Depression symptoms severe was measured using the Montgomery and Asberg Depression Rating Scale (MADRS) and Patient Health Questionnaire (PHQ-9). Global psychopathology was measured with the Brief Psychiatric Rating Scale (BPRS). Functional status, degree of disability and quality of life were assessed with the Global Assessment of Functioning (GAF), World Health Organization Disability Assessment Schedule II (WHODAS-II), and the 10-item Quality of Life in Epilepsy (QOLIE-10) respectively. ANOVA was used to analyze differences among group means. Fisher's exact and Chi square analysis was used to assess categorical variables. Results: In this sample, 15 (34.1%) had schizophrenia/schizoaffective disorder, 16 (36.4%) had bipolar disorder and 13(29.5%) had major depressive disorder. Although the groups did not statistically differ on demographic variables or variables relevant to both epilepsy care (seizure frequency, duration of epilepsy) and mental health care (psychiatric symptoms), there was a high level of depressive symptoms amongst the sample. Conclusions: In this sample of PLWE and psychiatric comorbidity, depressive symptoms were relatively severe and similar across groups with schizophrenia, bipolar disorder and major depressive disorder. Given the known negative consequence of depressive symptoms on PLWE, screening for depression with instruments such as PHQ-9 and the Neurological Disorders Depression Inventory for Epilepsy (NIDD-E) can help neurologists target and treat depression in this vulnerable group of PLWE. Funding: No funding