Bridging adolescence and adulthood: Mood disorders in the epilepsy transition population

OBJECTIVE: Adolescents and young adults (AYA) with epilepsy lack the knowledge or ability to appropriately manage their condition. As a result, they are at risk of poor medical and social outcomes (3). While AYA patients with underlying mood disorders are at risk for unsuccessful transfer of care, there have been limited studies assessing the frequency of mood disorders and associated risk factors among these patients. The purpose of this study was to evaluate the prevalence of anxiety and depression in the AYA population at two tertiary academic care centers in the Midwest and identify relevant risk factors. METHODS: AYA patients with epilepsy aged 16-26 years at Ohio State Wexner Medical Center (OSU) and Nationwide Children's Hospital (NCH) were enrolled into a transition registry. OSU enrolled 98 unique patients, and NCH enrolled 119 unique patients for a total of 217 participating patients. Each patient completed an epilepsy transition readiness assessment questionnaire (EPI-TRAQ), a validated assessment transition readiness tool. Binary logistic regression was used to model the probability of diagnosis with underlying mood disorder adjusting for age, sex and number of anti-seizure medications (ASMs) taken. RESULTS: In this study, 28 % of AYA patients were diagnosed with an underlying mood disorder. Females had 2.2 times higher odds of having a mood disorder compared to males (adjusted OR [aOR]: 2.22, 95% CI: 1.15-4.29). Additionally, patients who were 20 years of age or older and those who took two or more ASMs had associated significant increases in the odds of having a mood disorder. SIGNIFICANCE: This study highlights the need to increase the surveillance of underlying mood disorders for the AYA population. Three specific risk factors for anxiety and depression were identified in this study including age 20 or greater, sex assigned at birth as female and the use of two or more ASMs. Specific attention and early interventions should be focused on patients with increased risk factors.