Hispanic Students

Smith JAD, et al. Epilepsy & Behavior, 83(2018)1-6

People living with epilepsy are at increased risk of mood problems, including depression and anxiety, as compared to the general population. Difficulty with anxiety has also been reported as higher in people living with uncontrolled epilepsy. The management of mood and anxiety disorders are critical as they directly impact quality of life.

Previous studies have shown higher depression and lower quality of life in Spanish speaking immigrant persons with epilepsy, compared to U.S. born English speaking persons with epilepsy. Language barriers, inadequate epilepsy education, and misconceptions about epilepsy and its treatment have been documented in the Hispanic population.

Purpose

The goal of this study was to better understand the effect of epilepsy surgery on depression, anxiety, and quality of life in a Hispanic, primarily immigrant, Spanish speaking population with intractable or uncontrolled epilepsy.

Description of Study

  • Data were collected from a review of medical records from 47 patients.
  • People in this study were primarily immigrant (94%) Hispanic patients from an urban, public health, comprehensive epilepsy treatment center in Los Angeles, California. They had epilepsy surgery (resection of a seizure focus) for intractable epilepsy between 2008 and 2014.
  • Spanish speakers made up 70% of people and 30% self-identified as bilingual Spanish-English.
  • Before and one year after surgery tests were routinely done to assess depression (Beck Depression Inventory II), anxiety (Beck Anxiety Inventory), and quality of life (QOLIE-31).
  • Most people (92%) had seizures from the temporal lobe. Imaging studies (MRI, magnetic resonance imaging) showed mesial temporal sclerosis in 3 out of 4 people (74.5%).

Summary of Study Findings

  • After surgery, there was a significant improvement in tests for depression, anxiety, and quality of life.
  • The number of people with moderate to severe depression and anxiety was reduced by more than 50%.
    • The number of people with moderate to severe levels of depression declined from 37% to 15%.
    • The number of people with moderate to severe levels of anxiety declined from 33% to 9%.
  • There was no significant difference before and after surgery in relation to a person’s gender, education level, or which side of the brain was operated on.

What does this mean?

  • This study highlights improvement of depression, anxiety, and quality of life after epilepsy surgery in a unique subset of Hispanic people living in the Los Angeles area.
  • The population included in this study was primarily immigrant and Spanish speaking persons in underserved communities.
  • The authors reflect the increased level of access to quality care at a comprehensive epilepsy center and sensitivity to language and cultural factors by the center’s professional staff may have contributed to the improvement seen in people after surgery.
  • This study emphasizes the importance of being sensitive to different languages and cultures when treating persons with epilepsy.
  • Counseling before epilepsy surgery should be tailored to address the effect on mood and anxiety in different people.

Article published in Epilepsy & Behavior, June 2018.

Authored By: 
Elaine Kiriakopoulos MD, MSc
Authored Date: 
07/2018