Correlates of depressive symptom severity among adults with epilepsy participating in an epilepsy self-management clinical trial

Background People living with epilepsy (PWE) experience higher rates of depression compared with the general population. Depression in PWE is associated with increased seizure burden and reduced quality of life. We aimed to examine clinical and demographic correlates of depression severity using the nine-item Patient Health Questionnaire in PWE experiencing negative health events in the past 6 months. Aims (a) To assess how depressive severity correlated with seizure frequency; (b) To examine how outcomes such as quality of life are influenced by depressive severity; (c) To investigate how demographic factors affect depressive severity. Method Depressive severity was defined as a score of 0–9 for no depression to mild symptoms (NMD), 10–19 for moderate depression (MOD) and 20–27 for severe depression. Continuous variables were analysed using the Kruskal–Wallis equality-of-populations rank test, and categorical variables were compared using Fisher’s exact test. Baseline data were taken from Sequential, Multiple Assignment Randomized Trial no. NCT04705441. Results The sample of 159 participants had a mean age of 39.46 years (s.d., 12.15), with the majority ( n = 131, 82.4%) identifying as White. A total of 48% ( n = 76) of participants met the criteria for NMD, 41% ( n = 65) met those for MOD and 11% ( n = 18) met those for severe depression. The severe depression group had significantly more seizures in the past 30 days, as well as greater perceived stigma, lower social support and lower quality of life, compared with the other groups. Race was found to correlate with depressive severity in NMD and MOD versus the severe depression group. Conclusions Among adults with epilepsy, depressive severity was positively correlated with seizure frequency and stigma and negatively correlated with quality of life, social support and overall functioning. These results highlight the importance of routine screening for depression, and of providing management of these symptoms in comprehensive epilepsy care.