Abstracts

Rationale: Patients with epilepsy have high rates of psychiatric co-morbidities. Depression may affect an individual's perceived self-efficacy to manage his or her epilepsy. A number of factors can affect this perception, including the individual's support network, own attitude toward epilepsy, as well as their own cultural values that he or she identifies with. Little is known about the perceived self-efficacy in Hispanic patients with epilepsy despite the fact that Hispanics are the largest minority group in the U.S and at higher risk for depression. We therefore explored factors that influence depression among Hispanics with epilepsy and identified the effect of these factors on epilepsy self efficacy in this population. Methods: One hundred adult Hispanic patients are being recruited from The University of Arizona’s epilepsy clinic to respond to questionnaires related to depression, epilepsy self efficacy, acculturation, family involvement and criticism, and perceived stigma at baseline and at three months. Preliminary results from the first twenty patients are presented here. Results: Using the Patient Health Questionnaire (PHQ-9) to assess for depression, 50% of the patients were found to have mild to severe depression, while 50% are not depressed. When groups are compared for their epilepsy self efficacy score, as measured with the Epilepsy Self Efficacy Scale, the non-depressed group shows significantly higher mean self efficacy scores than those with depression (mean 8.9 vs. 6.9; p= 0.02). To evaluate social support, the Interpersonal Support Evaluation List (ISEL) was utilized. Total ISEL scores (of a possible total score of 40) demonstrated a significant difference between the groups (non depressed - 32.4 vs. depressed - 23.7, p= 0.02). The ISEL has four components that measure support for appraisal, belonging, tangible support, and self esteem. Depressed patients had significantly lower scores for appraisal (p=0.04), belonging (p=0.02), and tangible support (p=0.01). Self esteem is trending lower in depressed patients, but is not significant (p=0.08). No relationship between epilepsy self efficacy or depression was seen when evaluating for acculturation towards Anglo or Mexican culture. Conclusions: Depressed patients with epilepsy have significantly lower epilepsy self efficacy compared to patients with no depression. Evaluation of social support shows lower appraisal, belonging, and tangible support in the depressed group as well. Understanding the cultural effects on depression and its subsequent affect on epilepsy self efficacy may provide greater insight to treating epilepsy in this population. (Supported by a grant from the National EpiFellows Foundation).