Shaun Ajinkya1, Jonah Fox2, Alain Lekoubou3. 1. Department of Neurology, Medical University of South Carolina, Charleston, SC, USA. Electronic address: ajinkya@musc.edu. 2. Department of Neurology, Medical University of South Carolina, Charleston, SC, USA. 3. Department of Neurology, Penn State University Hershey Medical Center, Hershey, PA, USA.
Abstract
OBJECTIVE: Depressive symptoms are a common comorbidity among adults with epilepsy (AWE). Prior estimates regarding prevalence and treatment of depressive symptoms in AWE have been largely based on samples of tertiary care cohorts that may not be generalizable. We aimed to provide a representative population estimate of the prevalence and treatment of depressive symptoms over time in AWE in the United States as measured by a validated depression screen. METHOD: Data from the Medical Expenditure Panel Survey (MEPS) were analyzed from 2004 to 2015 to determine the prevalence of "screen positive" depressive symptoms (SPDS) among AWE as evaluated by the Patient Health Questionnaire-2 (PHQ-2). We defined pharmacotherapy for depressive symptoms as the prescription of any antidepressant, antipsychotic, anxiolytic, or central nervous system stimulant for the "Clinical Classification Code" of mood disorders within the year sampled, and psychotherapy as any outpatient or office-based visit for "mood disorders" for that year sampled. We analyzed temporal trends and explanatory variables for treatment using the Cochran-Armitage test and logistic regression, respectively. RESULTS: Our sample included 2024 AWE, representing 1,736,023 patients nationwide. This included 517 AWE with SPDS (AWE-SPDS), representing 401,452 AWE, and 1507 AWE who screened negative for depressive symptoms (AWE-SNDS), representing 1,334,571 AWE. The prevalence of SPDS was 23.1% (95% confidence interval [CI]: 20.6%-25.8%). Women (odds ratio [OR]: 1.40, 95% CI: 1.05-1.87), patients ages 35-49 (OR: 1.83, 95% CI: 1.23-2.72; compared with patients ages 18-34), and patients with Charlson Comorbidity Index ≥1 (OR: 1.92, 95% CI: 1.41-2.61) had higher odds of SPDS. There was no significant change in depressive symptoms' prevalence or treatment in AWE between the epochs of 2004-2006 and 2013-2015. CONCLUSIONS: Despite a quarter of AWE in the United States with SPDS, fewer than half received treatment. This indicates a need for improved efforts to screen AWE for depression and treat appropriately. Published by Elsevier Inc.
OBJECTIVE:Depressive symptoms are a common comorbidity among adults with epilepsy (AWE). Prior estimates regarding prevalence and treatment of depressive symptoms in AWE have been largely based on samples of tertiary care cohorts that may not be generalizable. We aimed to provide a representative population estimate of the prevalence and treatment of depressive symptoms over time in AWE in the United States as measured by a validated depression screen. METHOD: Data from the Medical Expenditure Panel Survey (MEPS) were analyzed from 2004 to 2015 to determine the prevalence of "screen positive" depressive symptoms (SPDS) among AWE as evaluated by the Patient Health Questionnaire-2 (PHQ-2). We defined pharmacotherapy for depressive symptoms as the prescription of any antidepressant, antipsychotic, anxiolytic, or central nervous system stimulant for the "Clinical Classification Code" of mood disorders within the year sampled, and psychotherapy as any outpatient or office-based visit for "mood disorders" for that year sampled. We analyzed temporal trends and explanatory variables for treatment using the Cochran-Armitage test and logistic regression, respectively. RESULTS: Our sample included 2024 AWE, representing 1,736,023 patients nationwide. This included 517 AWE with SPDS (AWE-SPDS), representing 401,452 AWE, and 1507 AWE who screened negative for depressive symptoms (AWE-SNDS), representing 1,334,571 AWE. The prevalence of SPDS was 23.1% (95% confidence interval [CI]: 20.6%-25.8%). Women (odds ratio [OR]: 1.40, 95% CI: 1.05-1.87), patients ages 35-49 (OR: 1.83, 95% CI: 1.23-2.72; compared with patients ages 18-34), and patients with Charlson Comorbidity Index ≥1 (OR: 1.92, 95% CI: 1.41-2.61) had higher odds of SPDS. There was no significant change in depressive symptoms' prevalence or treatment in AWE between the epochs of 2004-2006 and 2013-2015. CONCLUSIONS: Despite a quarter of AWE in the United States with SPDS, fewer than half received treatment. This indicates a need for improved efforts to screen AWE for depression and treat appropriately. Published by Elsevier Inc.
Authors: Giovanni Assenza; Mario Tombini; Jacopo Lanzone; Lorenzo Ricci; Vincenzo Di Lazzaro; Sara Casciato; Alessandra Morano; Anna Teresa Giallonardo; Carlo Di Bonaventura; Ettore Beghi; Edoardo Ferlazzo; Sara Gasparini; Loretta Giuliano; Francesco Pisani; Paolo Benna; Francesca Bisulli; Fabrizio A De Falco; Silvana Franceschetti; Angela La Neve; Stefano Meletti; Barbara Mostacci; Ferdinando Sartucci; Pasquale Striano; Flavio Villani; Umberto Aguglia; Giuliano Avanzini; Vincenzo Belcastro; Amedeo Bianchi; Vittoria Cianci; Angelo Labate; Adriana Magaudda; Roberto Michelucci; Annapia Verri; Gaetano Zaccara; Vincenzo Pizza; Paolo Tinuper; Giancarlo Di Gennaro Journal: Neurol Sci Date: 2020-06-10 Impact factor: 3.307