Abstracts

Rationale: As part of our usual care for adults with epilepsy, we evaluate patients for the presence of depressive symptoms. Since epilepsy is thought to be associated with labile mood symptoms, we performed ongoing surveillance of our patients in order to assess changes in mood symptoms across time.Methods: Consecutive adult patients at our Comprehensive Epilepsy Center were evaluated for depressive symptoms using the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR). At their next office visit at least 6 months later, the patients were re-evaluated using the exact same methodology performed by the same office personnel (our social worker). The scale has 16 items for response covering 9 domains and generally takes less than 5 minutes to complete. There are 4 degrees of response for symptoms over the past 7 days. The internal consistency of this scale is 0.86. The summated QIDS-SR scale score is categorized into 5 levels of possible depression: none <5, mild 6-10, moderate 11-15, severe 16-20 and very severe 21-27. The results of the scale were immediately discussed with the patient by a licensed clinical social worker and the decision to refer for further psychiatric intervention was based on the scale score and follow-up interview. Changes in scales scores were evaluated by paired T-tests and one-way Anova. Results: Thirty-five patients were re-evaluated 6-12 months after the initial evaluation. The mean initial QIDS score was 6.7 (SD 4.4) and the mean follow-up score was 6.8 (SD 4.6) which was not significantly different. There was no significant difference after covarying for number of months between evaluations. Patients with at least moderate (n=5) or mild (n=18) depression symptom scores also showed no significant change over time, although there was a trend toward improvement. All patients with at least mild depressive symptoms were already seeing a mental health care worker or refused further psychiatric intervention. Conclusions: Mood symptoms in adult outpatients with epilepsy appear to be stable over a time period spanning months. Therefore the initial mood assessment may be predictive of mood symptoms over the long term for patients with epilepsy.