Depression and mental health help-seeking behaviors in a predominantly African American population of children and adolescents with epilepsy

Epilepsia. 2009 Aug;50(8):1943-52. doi: 10.1111/j.1528-1167.2009.02046.x. Epub 2009 Feb 26.


Purpose: To determine whether previously undetected symptoms of depression and psychiatric help-seeking behaviors are associated with demographic or epilepsy-related variables in a predominantly African American sample of pediatric epilepsy patients.

Methods: Ninety-six serially recruited parent-child dyads (55% African American, 39% Caucasian) completed the Short Mood and Feelings Questionnaire (SMFQ). Regression analyses determined whether depressive symptoms measured by the SMFQ were associated with demographic (age, gender, and ethnic background) or epilepsy-related variables (age of seizure onset, duration of epilepsy, seizure type, time since last seizure, and number of antiepileptic drugs). Dyads with positive SMFQ screens (score > or = 12) received information about depression and were advised to seek mental health services. Six months later, parents completed follow-up interviews to ascertain mental health service utilization.

Results: Thirty-five participants (36.5%) screened positive for probable depression. Greater number of antiepileptic drugs was the only predictor variable independently associated with greater (worse) depression scores (p = 0.005). At 6-month follow-up, 12 patients (36.4%) had received mental health care, whereas 21 guardians (63.6%) denied depressive symptoms in their child and never sought mental health services (two dyads lost to follow-up). Logistic regression analyses found no associations between demographic, epilepsy-related, or depressive variables and psychiatric help-seeking.

Discussion: This study indicates the necessity and feasibility of screening for previously undetected symptoms of depression in pediatric epilepsy clinics serving diverse populations, particularly among patients receiving antiepileptic polytherapy. Additional research on the correlates of depressive symptoms and determinants of psychiatric help-seeking is needed to develop evidence-based interventions for youths with epilepsy and symptoms of depression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • African Americans / psychology*
  • Age Factors
  • Child
  • Depression / etiology*
  • Epilepsy / complications*
  • Epilepsy / psychology*
  • Female
  • Humans
  • Male
  • Mental Health Services / statistics & numerical data
  • Mental Health*
  • Patient Acceptance of Health Care* / ethnology
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Predictive Value of Tests
  • Psychiatric Status Rating Scales
  • Regression Analysis
  • Severity of Illness Index
  • Surveys and Questionnaires