Stability of Mood Symptoms in Adults with Epilepsy
An Interview with Cynthia Harden, MD

Sometimes people with epilepsy find themselves trapped in a cycle of depression that affects their ability to sleep and enjoy life. According to a study conducted by Cynthia Harden, MD, moods are predictive of mood symptoms over the long term for patients with epilepsy and one can determine this through an initial evaluation. The findings of Dr. Harden's study were reported at the 2007 American Epilepsy Society meeting this month. “What is important,” said Dr. Harden, “is that mood is important in terms of compliance with seizure medication. If we learn this at an initial evaluation we may be able to help these patients. So with this study, we performed ongoing surveillance of our patients in order to assess changes in mood symptoms across time.”

Methods and Results

The group evaluated 58 adult patients at Weill Cornell Medical College Comprehensive Epilepsy Center for depressive symptoms using the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR), followed up with a brief interview by the center’s social worker. The patients were reevaluated approximately 6 months later, using the exact same instrument. Additionally, the same social worker also performed the re-evaluation, which takes about 20 minutes, at that six-month follow-up visit.

Dr. Harden noted that “The mean initial QIDS score was 7.5 (SD 4.6) and the mean follow-up score was 7.1 (SD 4.5), which was not significantly different. The summated QIDS-SR scale score is categorized into 5 levels of possible depression: none <5, mild 6-10, moderate 11-15, severe 16-20 and very severe 21-27.”

She added that “Our licensed clinical social worker discussed the results immediately with the patient. Patients were referred for further psychiatric intervention if their scores indicated it was necessary. While many patients refused further psychiatric intervention, we were pleased that we had a person to talk with them.”

Conclusion

According to the abstract, the research team found that “Mood symptoms in adult outpatients with epilepsy appear to be stable over a time period spanning months. Therefore the initial mood assessment may be predictive of mood symptoms over the long term for patients with epilepsy.”

Dr. Harden added, “We will continue to refer depressed patients with epilepsy for psychiatric intervention because we would like to be able to help them and improve those scores. The good news is that their depression is stable. There is no wild fluctuation in mood. But the bad news is that they are not getting any better over time. Mood has a lot to do with AED compliance. We think that if patients are tested and evaluated, eventually we may be able to intervene and help them with their moods and ultimately achieve a better medication compliance rate. These data were collected at office visits, when compliance was being assessed.”

Abstract presented by:
C. Harden, L. Jovine, H. Quinn, D. Laba, L. Ponticello, P. Kandula, B. Nikolov

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