2012
American Epilepsy Society (Abst. 1.217)
Depression and quality of life in hispanic immigrants and us born epilepsy patients
Authors: M. A. Bonafina, M. Lancman, L. Myers, O. Laban, E. Feoli, E. Fertig, M. Lancman
Rationale:
Studies suggest that mood and anxiety disorders are more frequent among patients with epilepsy than in the general population. Mood and anxiety disorders are typically associated with indices of a poorer quality of life (QOL). The purpose of this study is to determine whether Hispanic immigrants with epilepsy present higher rates of depression and anxiety and reports of a lower quality of life than US-born epilepsy patients.
Methods:
The sample included 28 Hispanic immigrants and 27 controls (US born patients with epilepsy) who completed the Beck Depression Inventory-II (BDI-II), Beck Anxiety inventory (BAI), Quality of Life Inventory-31 (QOLIE-31), the Woodcock-Munoz Bateria (BIA), and the Wechsler Abbreviated Scales of Intelligence (WASI). Patients with associated non-epileptic seizures were excluded. A structured chart review was performed to select epilepsy, social, and psychological variables.
Results:
Of the 28 Hispanic patients, 8 were males and 20 females. For Hispanics, the mean age at the time of study was 44.28 ±3.029 years, mean education was 10.00 ±.768, mean age of epilepsy onset was 25.90 ±3.687. For the control group, 10 were males and 17 females. The mean age was 35.75 ±1.861 (p=0.021) and mean education was 13.15 ±.449. Educational attainment differed significantly between groups (p=0.001). Age of onset was 16.00 ±1.822 which is significantly younger than in the Hispanic group (p=0.026). The mean age at the time of testing was also significantly different (Hispanics: 44.28 ±3.029 and control group: 35.75 ±1.981). When BDI raw scores were compared, the Hispanic group mean was 24.71 ±3.098 and the control group mean was 14.61 ±2.143 (t=-2.742, p=0.008). In fact, 25/28 Hispanics (89%) BDI scores fell in the moderate to severe range of depression while the control group did so in 11/27 (41%). No significant differences were noted between the groups on QOLIE Total, Emotional Well-being, Social, Energy or Cognitive subscales. Of interest, on Emotional Well-Being, over 60 percent of respondents in both groups received a clinically impaired score on this subscale. No significant differences were noted between groups on a measure of anxiety (BAI). Intellectual functioning was significantly lower among Hispanic patients compared to the American group (BIA SS=79.75 ±2.208, WASI SS=91.35 ±2.562, t=-3.443, p=0.001). However, given that the tests used in both languages are different, the comparability of standard scores between the two is questionable.
Conclusions:
Hispanics with epilepsy reported significantly higher levels of depression than controls. The two groups showed equally poor Emotional Well-being (QOLIE-31) but did not differ significantly on this or other indices, or on anxiety. This suggests that both groups have an equally diminished quality of life, while a significantly higher number of Hispanics also qualify for clinical depression. This supports that direct assessment for mood pathology should be regularly conducted in this subpopulation.