213. Prevalence And Severity Of Depression Among Adolescents And Young Adults With Spina Bifida

Authors: Elizabeth Naylor Kuhn, MD; Betsy Hopson; Anastasia Arynchyna, MPH; Kathrin Zimmerman; Jeffrey Blount, MD; Brandon Rocque, MD, MS (Birmingham, AL)

Introduction:

There are limited data available on the prevalence and severity of depression in adolescents with spina bifida. Psychiatric illness during adolescence is of particular importance because these patients are preparing for transition to adult care, gaining independence, and taking increased ownership of their medical care.  Depression may negatively impact the success of transition, lead to poorer health-related quality of life, worsen chronic conditions, and increase healthcare utilization. 

The purpose of this study is to ascertain the prevalence and severity of depression in adolescent spina bifida patients.

Methods:

The Patient Health Questionnaire-9 (PHQ-9), a validated tool for screening, diagnosis, and measuring severity of depression, is routinely given to all patients 13 years and older in our Spina Bifida Clinic. The results of these prospectively-collected data were retrospectively reviewed for the period from March 2017 – June 2019. Additional data were collected from the National Spina Bifida Patient Registry.

Results:

The cohort included 106 patients; mean age was 16.7 years (SD: 2.4) and 54.7% of patients were male. Eighty-two patients (77.4%) had myelomeningocele and 76 patients (71.7%) had hydrocephalus. The lesion was thoracic in 19 patients (17.9%), lumbar in 73 patients (68.9%), and sacral in 14 patients (13.2%).

Mean PHQ-9 score was 3.2 (SD: 4.1) and 30 patients (28.3%) met criteria for depression (PHQ-9 ≥5). Twenty-two patients (20.8%) had mild depression, while six patients (5.7%) had moderate depression, and one patient (0.9%) each had moderately severe and severe depression. Prevalence of depression did not vary significantly with age, sex, diagnosis, hydrocephalus, or lesion level (p>0.05).

Conclusion:

In this population prevalence study, mild depression symptoms are relatively common in adolescents with spina bifida, though severe depression is uncommon. Interventions to address psychosocial wellness, such as presence of a psychotherapist or counselor in the multidisciplinary Spina Bifida Clinic, may be needed.