2011
American Epilepsy Society poster (Abst. 3.301)
Hispanic immigrants with epilepsy have a higher rate of depression compared to US born epilepsy patients
Authors: Drs. M. E. Lancman, L. Myers, O. Laban, P. Bailey, E. Feoli, E. Fertig
Rationale:
A higher prevalence of major depression has been reported in Hispanic immigrants as compared to European-Americans and other ethnic groups. Within epilepsy, mood disorders occur at a higher rate than in the general population. Our hypothesis is that Hispanic immigrants with epilepsy would present higher rates of depression than US-born epilepsy patients.
Methods:
The study included 28 Hispanic immigrants and 78 US born patients with epilepsy who consecutively underwent video-EEG monitoring and completed the Beck Depression Inventory-II (BDI-II) as part of a neuropsychological battery. Patients with associated non-epileptic seizures were excluded. A structured chart review was performed collecting select epilepsy, social, and psychological variables for each case.
Results:
Of the 28 Hispanic patients, 8 were males and 20 females. The mean age at the time of study was 40.9±2.6 years, mean epilepsy duration was 17.1±2.5 years and mean duration of education was 10.2 ±0.7. For the control group, 33 were males and 45 females. The mean age was 37.7±1.6, mean epilepsy duration was 15.1 ±1.6 and mean years of education was 13.0 ±0.3 (p.=0.001) When BDI raw scores were compared, the Hispanic group mean was 20.18 ±2.6 and the control group mean was 14.91 ±1,9 (t=-2.112, p=0.037). Specifically, BDI scores showed that 13/28 of Hispanics (46% ) fell in the moderate to severe depression range while the control group only did so in 20/78 (26% ). Associated variables were analyzed to determine whether these might play a role in this dissimilarity. None of the following variables differed significantly between the two groups: epilepsy type, epilepsy lateralization, etiology, working status, living in their own home, seizure frequency, number of AEDs, history of GTCSs and associated psychiatric disorders. Variables that did reveal significant differences included: greater proximity to family for the control group (p=0.003) and less daily activities out of the home for Hispanics (p=0.004).
Conclusions:
Hispanic immigrants with epilepsy reported significantly higher levels of depression compared to controls (US born epilepsy patients). The Hispanic patients differed in that they reported engaging less in daily activities out of home and had significantly less proximity to family than the control group. Given the preponderance of the cultural value of Familismo in Hispanic culture, the latter could be especially influential in the development or maintenance of a mood disorder. Although educational level was significantly different between both groups, it did not correlate with the BDI scores in our sample. Socio-economic status could possibly contribute to mood pathology, however necessary information to asses this variable was not available through chart review. These results suggest that this ethnic group may be at greater risk for mood disorders than the general population. Assessment for mood pathology in these patients should therefore be regularly conducted.