Authors :
Presenting Author: Deepak Lachhwani, MD – Cleveland Clinic
Gaelle Rached, MD – Cleveland Clinic
Dimitri Fiani, MD – Cleveland Clinic
Christina Deisz, LISW-S – Cleveland Clinic
Daniel Duffy, Ph.D. – Amwell
Kathryn Cseszneki, LISW – Cleveland Clinic
Nico Jayson, CNP – Cleveland Clinic
Tatiana Falcone, MD – Cleveland Clinic
Elia Pestana Knight, MD – Cleveland Clinic
Rationale:
According to the Behavioral Health Barometer 2020, 128,000 youth in Ohio (14.6% of all youth) had a depressive episode, with an estimated treatment gap of 53.5% for depression (SAMHSA). Youth with epilepsy are at higher risk of suffering from depression, and the lifetime prevalence is reported to be up to 50% in some studies (Kanner, 2003a). Access to treatment in youth with special health care needs may be worse than in the general population, putting these patients at risk for suicide (Kanner, 2003b), compounded by an already high prevalence of anxiety and depression within this population more generally (Barker et al., 2019).Methods:
This is a prospective study evaluating the effectiveness of a digital CBT intervention using an application, SilverCloud for Anxiety & Depression, in managing symptoms of depression and anxiety in adolescents with and without epilepsy. Eligible participants are between 14-18 years old and meet at least one of the following baseline criteria: a score greater than 60 on the RCADS, a score of ≥10 on the PHQ-9, or a score of ≥10 on the GAD-7. The primary outcomes are changes in PHQ-9 and GAD-7 scores over time, comparing adolescents with epilepsy to those without any chronic general medical conditions in relation to app usage.Results:
A total of 36 participants (mean age 16.6, 61.9% female) were enrolled in the study as of today. Of these participants, 17 (mean age 16.6, 64.7% female) had epilepsy and 19 (mean age 16.4, 63.2% female) did not have any chronic general medical conditions. Initial analyses show a significant improvement in PHQ9 and GAD7 scores in both groups. We found that increased app usage was associated with improvements in PHQ-9 and GAD-7 scores. In the last five months we have identified 8 CYE at risk for suicide and referred them to appropriate services.
Engagement of participants after recruitment is high; 89.5% of accounts have been activated following initial enrollment. Qualitative data reflects positive patient experience and engagement using the application.
Conclusions:
This preliminary analysis evaluates the effectiveness of using an online CBT intervention to reduce depression and anxiety symptoms in adolescents with epilepsy and without chronic general medical conditions. These findings highlight the potential of digital CBT that can reach broader populations cost-effectively and reduce the overall burden of mental illness.Funding: H98MC26260