Depression in Epilepsy and its Effect on Seizure Control among Patients in Neurology Referral Clinic at Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital, Addis Ababa, Ethiopia
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Date
2020-12
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Addis Abeba University
Abstract
Background: Depression is the most frequent comorbid psychiatric disorder in epilepsy. The
prevalence is 6-30% in developed countries and reaches approximately 50% in developing
countries, including Ethiopia. There is a bidirectional relationship between depression and
epilepsy. The seizures themselves or the anticonvulsant drugs can provoke depression in
patients with epilepsy. Anti-depression medications can also lower the seizure threshold and
provoke seizure.
Objective: The study was conducted to assess socio-demographic characteristics and
prevalence of depression in epilepsy and its impact on seizure control among epilepsy patients
on follow up at Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital neurology
referral clinic.
Method: A multi-institutional prospective cross-sectional study design was conducted from
June 20, 2020 to October 30, 2020 at Tikur Anbessa Specialized Hospital and Zewditu
Memorial hospital epilepsy follow up clinic. A stratified sampling method was used to collect
data using a semi-structured questionnaire. The study participants were epilepsy patients who
are on anti-epileptic drug treatment during the study period.The questionnaire comprises of
basic demographic data, clinical variable and PHQ-9. Data analysis was conducted using
SPSS version 25, descriptive statistics were used to describe the characteristics of the study
participants. The results were summarized and described using tables. A logistic regression
analysis was used to assess the association between seizure control and depression and P value
of <0.05 was considered significant.
Result: Of the 247 study participants, 128(51.8%) were females. The mean age was 30.7 ±
12.47 years. Co-morbid illness was present in 85(34.4%) with neurological diseases being the
commonest. 137 (55.5%) of the respondents were seizure free in previous one year. The
prevalence of depression in this study population was 38.1%. Presence of depression and the
use of polytherapy was associated with poor seizure control.
Conclusion: The prevalence of depression in epilepsy is high. The presence of depression and
polytherapy use were significantly associated with poor seizure control.
Recommendations: Epilepsy patients should be evaluated for presence of depression using
screening tools as it helps in better management of seizure control.
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Keywords
Depression, epilepsy, and seizure control