Department of Neurology, New York University Langone Health, 222 East 41st Street, 9th Fl, New York, NY 10017, United States.
Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 10900 Euclid Ave, Cleveland, OH 44106, United States.
Epilepsy Behav. 2021 Dec;125:108388. doi: 10.1016/j.yebeh.2021.108388. Epub 2021 Nov 16.
Although psychiatric disorders are more common among people with epilepsy, depression and suicidal ideation among Hispanics with epilepsy remain understudied. We examined the prevalence and correlates of depression and suicidal ideation among Hispanic adults with epilepsy who participated in self-management studies in the Managing Epilepsy Well Network.
This cross-sectional analysis of pooled data from ten studies used the Patient Health Questionnaire-9 or Neurological Disease Depression Inventory-Epilepsy to examine the prevalence of elevated depressive symptoms (PHQ ≥ 10, NDDI-E ≥ 15) and suicidal ideation (PHQ-9 item 9 ≥ 1, NDDI-E item 4 ≥ 2). Multilevel mixed-effects logistic regression models examined associations between ethnicity, elevated depressive symptoms, and suicidal ideation among PWE. Secondary analyses examined correlates of elevated depressive symptoms and suicidal ideation among Hispanic PWE.
Of 559 participants, 49.6% (n = 277) were Hispanic. Elevated depressive symptoms were endorsed by 38.1% (n = 213) of all participants (32.5% of Hispanics); suicidal ideation was endorsed by 18.4% (n = 103) of all participants (16.3% of Hispanics). After adjustment for sociodemographic and health attributes, Hispanic PWE had a 44% lower prevalence of elevated depressive symptoms (OR = 0.56, CI 0.37-0.84, p = 0.0056) compared to non-Hispanics but similar rates of suicidal ideation (OR = 0.84, CI 0.45-1.58, p = 0.59). Acculturation measures were available for 256 (92.4%) of Hispanic PWE: language preference was Spanish for 62.9%, 46.1% were foreign-born. Spanish-speaking Hispanics were less likely than English-speaking Hispanics to report elevated depressive symptoms (OR = 0.43, CI 0.19-0.97, p = 0.041); however, Hispanics who reported fair or poor health status had a four-fold higher depression prevalence compared to those who reported excellent or very good health status [reference group] (OR = 4.44, CI 1.50-13.18, p = 0.0071). Of the Hispanics who provided prior 30-day seizure data, ≥1 monthly seizure was independently associated with higher depression prevalence (OR = 3.11, CI 1.29-7.45, p = 0.01). Being foreign-born was not associated with elevated depressive symptoms or suicidal ideation prevalence.
In a large, geographically diverse sample of PWE, elevated depressive symptoms were significantly lower in Hispanics compared to non-Hispanics. Spanish language preference was associated with a lower prevalence of elevated depressive symptoms among Hispanic PWE. Future studies should include acculturation data to better screen for depression and suicidal ideation risk and optimize interventions for Hispanic PWE.
尽管精神障碍在癫痫患者中更为常见，但西班牙裔癫痫患者的抑郁和自杀意念仍研究不足。我们研究了参加 Manage Epilepsy Well 网络自我管理研究的西班牙裔成年癫痫患者中抑郁和自杀意念的患病率及其相关因素。
这是一项对来自 10 项研究的汇总数据进行的横断面分析，使用患者健康问卷-9 或神经病学疾病抑郁量表-癫痫来检查抑郁症状升高（PHQ≥10，NDDI-E≥15）和自杀意念（PHQ-9 项目 9≥1，NDDI-E 项目 4≥2）的患病率。多水平混合效应逻辑回归模型检查了种族、升高的抑郁症状和 PWE 中的自杀意念之间的关联。次要分析检查了西班牙裔 PWE 中升高的抑郁症状和自杀意念的相关因素。
在 559 名参与者中，49.6%（n=277）为西班牙裔。所有参与者中有 38.1%（n=213）报告有升高的抑郁症状（西班牙裔中有 32.5%）；所有参与者中有 18.4%（n=103）报告有自杀意念（西班牙裔中有 16.3%）。调整社会人口统计学和健康属性后，与非西班牙裔相比，西班牙裔 PWE 升高的抑郁症状患病率降低了 44%（OR=0.56，CI 0.37-0.84，p=0.0056），但自杀意念的发生率相似（OR=0.84，CI 0.45-1.58，p=0.59）。在 256 名（92.4%）西班牙裔 PWE 中提供了文化适应措施：62.9%的人首选西班牙语，46.1%的人是外国出生。与讲英语的西班牙裔相比，讲西班牙语的西班牙裔报告升高的抑郁症状的可能性较低（OR=0.43，CI 0.19-0.97，p=0.041）；然而，报告健康状况不佳的西班牙裔与报告健康状况极好或非常好的西班牙裔相比，抑郁患病率高四倍[参考组]（OR=4.44，CI 1.50-13.18，p=0.0071）。在提供了过去 30 天癫痫发作数据的西班牙裔中，每月≥1 次癫痫发作与更高的抑郁患病率独立相关（OR=3.11，CI 1.29-7.45，p=0.01）。外国出生与升高的抑郁症状或自杀意念患病率无关。
在一个来自不同地理位置的 PWE 的大型、多样化样本中，与非西班牙裔相比，西班牙裔 PWE 中升高的抑郁症状明显较低。西班牙语偏好与西班牙裔 PWE 中升高的抑郁症状患病率降低有关。未来的研究应包括文化适应数据，以更好地筛查抑郁和自杀意念风险，并优化西班牙裔 PWE 的干预措施。
