Analyzing depression coping strategies of patients with epilepsy: a preliminary study

To determine whether individuals with epilepsy who are depressed have different coping reactions, such as increased use of disengagement-type coping reactions, compared to those who are not.

We surveyed 200 patients with epilepsy and obtained demographic and clinical information. We used the Neurological Institute Disorders Depression Inventory for Epilepsy (NIDDI-E) to determine those patients who had a major depression (NIDDI-E score >15) and administered the Quality of Life in Epilepsy-10 Inventory (QOLIE-10), Beliefs About Medicines Questionnaire-Specific, Sheehan Disability Scale, a screening question for health literacy ("How confident are you filling out medical forms by yourself?"), and the Brief Coping with Problems Experienced (Brief-COPE). Using univariate analysis, we determined those demographic and clinical variables that were associated with depression. We also determined the coping reactions more frequently utilized by individuals with depression, and using multivariate analysis, determined whether those coping reactions retained statistical significance. We performed subgroup analysis of depressed epilepsy patients to determine whether coping reactions they preferentially utilized were associated with seizure frequency and quality of life.

Seventy-one patients had a major depression while 128 did not. On univariate analysis, not driving, not working, higher seizure frequency, experiencing convulsions, poorer quality of life, and higher disability scores were significantly associated with major depression. These individuals used denial more often as a coping reaction. On multiple linear regression, the association between the use of denial and being depressed retained statistical significance. The mean denial coping scores were higher among depressed patients with more frequent seizures. However, this did not reach statistical significance.

Individuals with epilepsy who have a major depression utilize denial more often as a coping reaction. Realizing this is of value to caregivers as they help patients deal with their stressful situation. This also provides additional impetus to more effectively and aggressively treatment depression in the epilepsy population.