PHILADELPHIA – Integration of mental health care screenings for children with epilepsy can aid in early referral of at-risk patients, potentially reducing time to treatment and saving lives.
The research was presented at the 2015 American Epilepsy Society Annual Meeting in Philadelphia.
Previous research has documented the increased rate of mental health issues among children with epilepsy, including depression, suicidal ideation, and suicidal or parasuicidal behavior.
In this study, Tatiana Falcone, MD, of the Cleveland Clinic, and colleagues sought to examine the feasibility and sensitivity of performing an algorithm-based mental health screening during an epilepsy appointment.
Researchers performed a total of 5303 mental health screenings for 400 children with epilepsy from 2008 through 2015. Patients were administered the Patient Health Questionnaire 2 (PHQ-2) and then screening proceeded based on the algorithm.
Of the 400 participants screened, 106 (26.5%) screened positive for suicide. Male/female ratio was nearly equal for those that screened positive. Overall, 12 patients were referred to the Emergency Department, with 13 suicides prevented.
In a sub-sample of patients who screened positive for suicide (n=13; 9 female, 4 male; ages 9-18 years), all patients reported suicidal ideation, with suicide attempts ranging from 0-3, with 12 total. Half of the patients reported thoughts of harming others. All of the patients were taking selective serotonin reuptake inhibitors, with 10 of 13 patients diagnosed with focal epilepsy. The overall mean score for the Screen for Child Anxiety Related Disorders (SCARED) was 47.69, which was significant for clinical anxiety; mean score for the Children Depression Inventory (CDI) was 88.3, which was significant for depression; and the mean score of the Adverse childhood experiences screen was 2.
Overall, the algorithm proved useful in organizing and systemizing the mental health screening process. Integrating mental health care screening during epilepsy visits at least every 6 months may help facilitate early referral, treatment, and suicide prevention in children with epilepsy.
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- Falcone T, Pestana-Knight E, Hagen D, et al. Abstract 1.009. Screening for suicidal ideation and behavior among youth with epilepsy can save lives. Presented at: American Epilepsy Society Annual Meeting; Dec 4-8; Philadelphia.