Epilepsy

Adult Epilepsy: Effect of Treatment on Mood

2008 - 2021

Mood disorders, especially depression, are common in patients with epilepsy. The Epilepsy Center routinely screens for depressive symptoms using the Patient Health Questionnaire (PHQ-9) to identify and treat depression as soon as possible, using primary care depression treatment guidelines.¹ Early identification and treatment should result in improvement in patients’ care, given the significant effect of depression on quality of life.

Change in Depressive Symptoms in Adult Epilepsy Patients

2008 – 2021

For patients with at least moderate depressive symptoms (defined as PHQ-9 scores ≥ 10), a clinically meaningful improvement was seen in 57% of the medical group and 58% of the surgical group.

Clinically meaningful change was defined as a total point change of ≥ 5 points.¹

Mean duration of follow-up was 1745 days (range, 180-5043) in the medical group and 1148 days (range, 181-4432) in the surgical group.

Change in Global Mental Health in Adult Epilepsy Patients

2013 – 2021

Medical Patients (N = 3170)

7722 medically treated patients had at least 2 visits with PROMIS-10 Mental Health data available for analysis. Among those patients whose baseline PROMIS-10 Mental Health score ≤ 45 (N = 3170), 31.6% (N = 1001) showed improvement, 54% (N = 1713) remained stable, and 14.4% (N = 456) worsened. Median duration of follow-up was 1074 days (range, 180-2608).

Surgical Patients (N = 93)

163 surgical patients had a presurgery visit and postsurgery visit with PROMIS-10 Mental Health data available for analysis. Among those patients whose baseline PROMIS-10 Mental Health score ≤ 45 (N = 93), 38.7% (N = 36) showed improvement, 43% (N = 40) remained stable, and 18.3% (N = 17) worsened. Median duration of follow-up was 770 days (range, 188-1876). Clinically meaningful change was defined as a 5-point change in T-score, based on one-half the standard deviation.²

References
  1. Lowe B, Unutzer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the Patient Health Questionnaire-9. Med Care. 2004 Dec;42(12):1194-1201
  2. Cella D, Yount S, Rothrock N , et al . The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years. Med Care 2007;45:3–11