title: Depression and genetic causal attribution of epilepsy in multiplex epilepsy families.
abstract: OBJECTIVE
  Rapid advances in genetic research and increased use of genetic testing have increased the emphasis on genetic causes of epilepsy in patient encounters. Research in other disorders suggests that genetic causal attributions can influence patients' psychological responses and coping strategies, but little is known about how epilepsy patients and their relatives will respond to genetic attributions of epilepsy. We investigated the possibility that among members of families containing multiple individuals with epilepsy, depression, the most frequent psychiatric comorbidity in the epilepsies, might be related to the perception that epilepsy has a genetic cause.
  
  
  METHODS
  A self-administered survey was completed by 417 individuals in 104 families averaging 4 individuals with epilepsy per family. Current depression was measured with the Patient Health Questionnaire. Genetic causal attribution was assessed by three questions addressing the following: perceived likelihood of having an epilepsy-related mutation, perceived role of genetics in causing epilepsy in the family, and (in individuals with epilepsy) perceived influence of genetics in causing the individual's epilepsy. Relatives without epilepsy were asked about their perceived chance of developing epilepsy in the future, compared with the average person.
  
  
  RESULTS
  Prevalence of current depression was 14.8% in 182 individuals with epilepsy, 6.5% in 184 biologic relatives without epilepsy, and 3.9% in 51 individuals married into the families. Among individuals with epilepsy, depression was unrelated to genetic attribution. Among biologic relatives without epilepsy, however, prevalence of depression increased with increasing perceived chance of having an epilepsy-related mutation (p = 0.02). This association was not mediated by perceived future epilepsy risk among relatives without epilepsy.
  
  
  CONCLUSIONS
  Depression is associated with perceived likelihood of carrying an epilepsy-related mutation among individuals without epilepsy in families containing multiple affected individuals. This association should be considered when addressing mental health issues in such families.
authors: GH Sergievsky Center, Columbia University, New York, New York, U.S.A.
authors: Shawn T
authors: ST
authors: Sorge
authors: GH Sergievsky Center, Columbia University, New York, New York, U.S.A.|Department of Epidemiology, Columbia University, New York, New York, U.S.A.
authors: Dale C
authors: DC
authors: Hesdorffer
authors: Department of Sociomedical Sciences, Columbia University, New York, New York, U.S.A.
authors: Jo C
authors: JC
authors: Phelan
authors: GH Sergievsky Center, Columbia University, New York, New York, U.S.A.|Department of Neurology, Columbia University, New York, New York, U.S.A.
authors: Melodie R
authors: MR
authors: Winawer
authors: Department of Sociology, Brandeis University, Waltham, Massachusetts, U.S.A.
authors: Sara
authors: S
authors: Shostak
authors: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, U.S.A.
authors: Jeff
authors: J
authors: Goldsmith
authors: Department of Pediatrics, Columbia University, New York, New York, U.S.A.|Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, U.S.A.
authors: Wendy K
authors: WK
authors: Chung
authors: GH Sergievsky Center, Columbia University, New York, New York, U.S.A.. ro6@columbia.edu.|Department of Epidemiology, Columbia University, New York, New York, U.S.A.. ro6@columbia.edu.|Department of Neurology, Columbia University, New York, New York, U.S.A.. ro6@columbia.edu.|Division of Epidemiology, New York State Psychiatric Institute, New York, New York, U.S.A.. ro6@columbia.edu.
authors: Ruth
authors: R
authors: Ottman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003863:Depression / Q000453:epidemiology*; D004827:Epilepsy / Q000453:epidemiology* / Q000235:genetics* / Q000523:psychology; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011594:Psychometrics; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Depression; Epidemiology; Epilepsy; Genetic attribution; Genetics