Abstract

Objective: Depression is the most common psychiatric comorbidity among people with epilepsy (PWE) and tends to be more prevalent among people of color (POC) and those with intractable seizures. However, the extent to which illness-related perceptions are associated with depressive symptom severity among POC with intractable seizures is unclear. Method: This cross-sectional study examined relationships among illness representations and self-rated depressive symptoms in 55 PWE (M Age = 41; 61.8% female) with intractable seizures (M seizures per month = 2) who identified as Black/African-American (52.7%), Black/Caribbean-American (27.3%), and/or Hispanic/Latino (21.8%). Epilepsy-related illness perceptions were assessed with the Illness Perception Questionnaire-Revised and depression was measured via the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Results: Nearly half of the sample (41.8%) scored above the NDDI-E depression cut-off. PWE endorsing more severe depressive symptoms indicated that their epilepsy had more negative consequences, was hard to comprehend, was insufficiently controlled by treatment, and had a negative emotional impact (p’s ≤ 0.02). Controlling for sex, these four illness representations accounted for 48% of the variance in depression severity. Interestingly, participants with probable major depressive episodes were more likely to endorse several psychological causes of seizures compared to non-depressed PWE. Conclusions: Worse depression symptom severity was associated with negative illness perceptions and a tendency to attribute one’s epilepsy to psychological causes. Future research is needed to understand how the relationship between negative illness perceptions and depression symptoms unfold over time and whether interventions aimed at modifying illness representations reduce psychological distress in diverse PWE.

摘要

目的：抑郁症是癫痫 (PWE) 患者中最常见的精神疾病，在有色人种 (POC) 和难治性癫痫患者中更为普遍。然而，在难治性癫痫发作的 POC 中，疾病相关认知与抑郁症状严重程度的相关程度尚不清楚。方法：这项横断面研究检查了 55 名 PWE（M年龄 = 41；61.8% 女性）患有顽固性癫痫发作（M每月癫痫发作 = 2)，他们被确定为黑人/非洲裔美国人 (52.7%)、黑人/加勒比裔美国人 (27.3%) 和/或西班牙裔/拉丁裔 (21.8%)。与癫痫相关的疾病感知通过修订的疾病感知问卷进行评估，抑郁症通过癫痫神经障碍抑郁量表 (NDDI-E) 进行测量。结果：近一半的样本 (41.8%) 得分高于 NDDI-E 抑郁临界值。PWE 认可更严重的抑郁症状表明他们的癫痫具有更多的负面后果，难以理解，治疗控制不足，并具有负面的情绪影响（p的 ≤ 0.02)。控制性别，这四种疾病表现占抑郁症严重程度差异的 48%。有趣的是，与非抑郁 PWE 相比，可能患有重度抑郁发作的参与者更有可能支持癫痫发作的几种心理原因。结论：更严重的抑郁症状与消极的疾病认知以及将癫痫归因于心理原因的倾向有关。未来的研究需要了解负面疾病感知与抑郁症状之间的关系如何随着时间的推移而展开，以及旨在改变疾病表征的干预措施是否会减少不同 PWE 的心理困扰。