1. Introduction A higher prevalence of major depression has been reported in Hispanic immigrants as compared to non Hispanic Caucasians. In fact, they are considered a “high risk group for depression” as per the National Association of Mental Illness Multicultural Outreach Center. Depressive disorders in epilepsy occur at a higher rate than in the general population and are actually the most common type of psychiatric co- morbidity in patients with epilepsy. Our hypothesis is that Hispanic immigrants with epilepsy would present higher rates of depression than US-born non Hispanic Caucasian epilepsy patients because they are considered a “high risk group” due to their ethnicity. Hispanics immigrants with epilepsy have a higher rate of depression compared to US born epilepsy patients Marcelo Lancman MD, Lorna Myers, PhD, Olgica Laban-Grant, MD, Paola Bailey PsyD, Enrique Feoli, MD and Evan Fertig, MD Northeast Regional Epilepsy Group, NY, NJ, and CT, USA. Conclusions Hispanic immigrant epilepsy patients showed higher levels of depression compared to US born epilepsy patients(controls). In our Latino sample, patients differed from the control group on distance from family. In all socio- cultural groups, a strong social support system has a positive counteractive effect on mental illness risk factors. In the Latino culture social support typically comes in the form of family (Familismo). Therefore, distance from family could be a likely contributor to higher rates of distress and mood disorder. a lower rate of outside activities may represent a consequence of depression; financial limitations and distance from family (since many activities are done as a group). Limitations: Measurement of social economic status (SES) was not possible because the necessary information was not collected on interview. Significantly lower education may be reflecting lower SES which has been reported to be a contributing factor in depression and should be studied in the future. Methods Twenty-eight consecutive Hispanic immigrants and 78 US born patients with epilepsy were included in the study. All patients underwent video-EEG monitoring and were administered a Beck Depression Inventory (English or Spanish version-BDI) as part of their neuropsychological assessment. The BDI is a 21-item, multiple choice self report questionnaire that assesses severity of depression. BDI raw scores were used for analysis. Patients with associated non-epileptic seizures were excluded Statistical analysis: -Chi square was used for comparison of categorical variables between the 2 groups (Hispanics and controls) -Independent Student’s t test was used to compare numerical variables between the 2 groups (Hispanics and controls) -Pearson correlation to correlate numerical variables Of the 28 Hispanic patients, 8 were males/ 20 females, mean age was 40.9 years, mean epilepsy duration was 17.1 years and mean years of education was 10.2 (±0.7). For the control group, 33 were males/45 females, mean age was 37.7, mean epilepsy duration was 15.1 and mean years of education was 13.0 (±0.3) Results A comparison of BDI raw scores revealed: the group mean for Hispanics was 20.18 (±2.6) (moderate depression) and the control was 14.91 (±1,9) (mild depression) (t=-2.112, p=0.037). In order to explain the difference other variables were analyzed.  No significant differences between the two groups were found regarding epilepsy type, epilepsy lateralization, etiology, working status, having a home, seizure frequency, number of AEDs, history of generalized tonic clonic seizures (GTCSs) and associated psychiatric disorders.  Two variables that showed significant differences: proximity to family - higher for the control group (p=0.003) and daily activities out of the home (p=0.004) - lower for Hispanics. There was also a significant difference between the two groups in education which did not have an independent effect on depression (p.=0.001).