This abstract is a recipient of the Gaps in Practice Research Award This abstract is recognized by Partners Against Mortality in Epilepsy for its contribution to improving the understanding of epilepsy-related mortality
Rationale: Depression and anxiety are most common psychiatric comorbidities in children and youth with epilepsy (CYE)1,2,3 and known to contribute to suicidality among them. However, not much is known about suicidality in CYE lacking established psychiatric comorbidities.4 The problem with suicidality in CYE is compounded by the fact that death by suicide is the second leading cause of mortality between the ages of ten and 24 in the general population. 5 Our research aims to fill this knowledge gap and correlate latent suicidality with screening tests for depression and anxiety. Methods: After IRB approval, CYE who attended epilepsy clinic or underwent testing in the pediatric epilepsy monitoring unit at the Cleveland Clinic and lacked established psychiatric diagnosis were enrolled in the study. They filled out self-reported, validated scales for screening and diagnosis of depression, anxiety and suicidality [Center for Epidemiological Studies Depression Scale for Children (CES-DC), Screen for Child Anxiety Related Emotional Disorders (SCARED), and The Ask Suicide‐Screening Questions (ASQ), respectively]. Univariate descriptive statistics along with χ2 test of association and independent student’s t-test were performed for statistical analysis. Results: A total of 119 (54.6% females) CYE were included in the study. Close to a third (30.2%) of CYE were positive for anxiety on SCARED and 41.2% were positive for depression based on CSE-DC scoring. A total of 13 (10.9%) CYE indicated suicidality by answering at least one positive response on ASQ. Those who scored at least one positive on the ASQ had a mean score of 32.08 (σ = 17.37) on the SCARED, compared to a mean of 18.30 (σ = 13.62) among those who did not score at least one positive on the ASQ (t = 3.30, df = 103, p = .003, d = 0.88). Cohen’s d indicates a positive, strong difference between the mean scores of those who had at least one positive ASQ item and those who did not. The SCARED had a low positive correlation with the ASQ (r = 0.32), but moderate positive correlation with the CES-DC (r = 0.64). Table 1 presents the characteristics of the SCARED, CES-DC, and ASQ. Over 26% (26.7%, n = 12) of participants who scored 16 or higher on the CES-DC indicated at least one positive response on the ASQ. This is statistically significantly higher than those who scored 15 or below on the CES-DC (1.5%, n = 1; χ2 = 16.11, p < .0001). Conclusions: We found previously undiagnosed depression and anxiety in a large percentage of CYE. The use of self-reported psychiatry inventory tools revealed unrecognized suicidality in one out of ten CYE lacking previously recognized psychiatric disorders. This highlights the importance of using psychiatry screening tests in all CYE. Future research using larger, diversified cohort are needed to confirm our findings.
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Funding: Please list any funding that was received in support of this abstract.: Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS).(Grant H98MC26260) Click here to view image/table