Abstracts

Rationale: Adolescents and young adults (AYA) with underlying mood disorders are at risk for unsuccessful transfer of care (1). The purpose of this study was to evaluate the prevalence of anxiety and depression in the AYA population at two tertiary academic care centers in the midwest and identify relevant risk factors.


Methods: AYA patients with epilepsy ages 16-26 years at Ohio State Wexner Medical Center (OSU) and Nationwide Children’s Hospital (NCH) were enrolled into a transition registry. OSU prospectively enrolled 98 unique patients and NCH retrospectively enrolled 119 unique patients for a total of 217 participating patients. Each patient completed an Epilepsy Transition Readiness Assessment Questionnaire (EPI-TRAQ), a validated assessment transition readiness tool. EPITRAQ scores, demographics, epilepsy characteristics, anti-seizure medications, and comorbid mood disorders (specifically anxiety and depression) were collected for each patient.


Results: 28% of patients (61/217) were diagnosed with an underlying mood disorder. There was a statistically significant increase in mood disorders in AYA patients that were 20 years of age and older (p = 0.0065), in patients that had an assigned sex of female at birth (p=0.0063), and patients that were taking two or more anti-seizure medications (p=0.0325). Using binary logistic regression, females had 2.4 times significantly higher odds of having a mood disorder compared to males adjusting for age and number of ASMs.


Conclusions: Based on our findings, there is an increase in underlying mood disorders in the AYA population ages 16-26 (28%) compared to the reported frequency of 20% and 22% (for anxiety and depression respectively) in the total epilepsy population (2).

Patients that were 20 years and older had a significant increase in anxiety and depression (39% with mood disorders in comparison to 27% without mood disorders from ages 20-23) compared to ages 16-19. Other significant risk factors for anxiety and depression included a female sex assigned at birth and taking 2 or more anti-seizure medications. Specifically, females were 2.4 times more likely to have an underlying mood disorder when compared to males and even when adjusted for age and number of ASMs.

In conclusion, this highlights the need to increase surveillance of underlying mood disorders during the age of 20 years and older and implement interventions even before this age. It is unclear whether patients are under reporting mood disorders at a younger age or if there is an increase in social changes which are impacting patients’ moods. It will be also important to have more targeted interventions to the female AYA population. Identifying and improving mood disorders may facilitate more successful transfers of care.

1. Caplan R, Siddarth P, Gurbani S, Hanson R, Sankar R, Shields WD. Depression and anxiety disorders in pediatric epilepsy. Epilepsia. 2005 May;46(5):720-30
2. Scott AJ, Sharpe L, Hunt C, Gandy M. Anxiety and depressive disorders in people with epilepsy: A meta-analysis. Epilepsia. 2017 Jun;58(6):973-982


Funding: Pediatric Epilepsy Research Foundation, Neurology at OSU