Comorbid mental disorders and quality of life of people with epilepsy attending primary health care clinics in rural Ethiopia

Tsigebrhan, Ruth; Fekadu, Abebaw; Medhin, Girmay; Newton, Charles R.; Prince, Martin; Hanlon, Charlotte

doi:10.1371/journal.pone.0238137

Cited by 10 publications

(11 citation statements)

References 45 publications

(71 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been shown that the numbers and doses of ASMs can modulate the seizure frequency and effects on the QOL to cause multiple psychological disorders like abnormal behavior, stigma, physical impairments, or other mental co-morbidities like social, behavioral, physiological, or psychological well-being. In a study, stigma was found to be associated with seizure severity and it showed a poorer quality of life [ 19 , 20 ]. The effect of ASMs in PWE resulted in a worse quality of life due to enriched seizure episodes, adverse effects, psychological issues, and various etiological aspects that may lead to medical co-morbidities.…”

Section: Introductionmentioning

confidence: 99%

Anti-seizure medications and quality of life in person with epilepsy

Dwivedi

Tiwari²,

Tripathi³

2022

Heliyon

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Anti-seizure medications and quality of life in person with epilepsy

Dwivedi

Tiwari²,

Tripathi³

2022

Heliyon

View full text Add to dashboard Cite

“…Neither the primary health care facility nor the PHC workers are equipped with this skill or resource. The low detection of anxiety disorders in this study could also be due to the presentation of depression in Ethiopian culture, which tends to be a combination of anxiety, somatic and depressive symptoms rather than typical DSM criteria, alongside the non-biomedical causal attributions of depressive/anxiety symptoms in this society [ 27 ]. It is possible that psychiatry nurses tended to prioritise a diagnosis of depression over anxiety disorders as this reflected their experince of presentation in clinical settings.…”

Section: Discussionmentioning

confidence: 99%

Performance of primary health care workers in detection of mental disorders comorbid with epilepsy in rural Ethiopia

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Timely detection and management of comorbid mental disorders in people with epilepsy is essential to improve outcomes. The objective of this study was to measure the performance of primary health care (PHC) workers in identifying comorbid mental disorders in people with epilepsy against a standardised reference diagnosis and a screening instrument in rural Ethiopia. Methods People with active convulsive epilepsy were identified from the community, with confirmatory diagnosis by trained PHC workers. Documented diagnosis of comorbid mental disorders by PHC workers was extracted from clinical records. The standardized reference measure for diagnosing mental disorders was the Operational Criteria for Research (OPCRIT plus) administered by psychiatric nurses. The mental disorder screening scale (Self-Reporting Questionnaire; SRQ-20), was administered by lay data collectors. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PHC worker diagnosis against the reference standard diagnosis was calculated. Logistic regression was used to examine the factors associated with misdiagnosis of comorbid mental disorder by PHC workers. Results A total of 237 people with epilepsy were evaluated. The prevalence of mental disorders with standardised reference diagnosis was 13.9% (95% confidence interval (CI) 9.6, 18.2%) and by PHC workers was 6.3% (95%CI 3.2, 9.4%). The prevalence of common mental disorder using SRQ-20 at optimum cut-off point (9 or above) was 41.5% (95% CI 35.2, 47.8%). The sensitivity and specificity of PHC workers diagnosis was 21.1 and 96.1%, respectively, compared to the standardised reference diagnosis. In those diagnosed with comorbid mental disorders by PHC workers, only 6 (40%) had SRQ-20 score of 9 or above. When a combination of both diagnostic methods (SRQ-20 score ≥ 9 and PHC diagnosis of depression) was compared with the standardised reference diagnosis of depression, sensitivity increased to 78.9% (95% (CI) 73.4, 84.4%) with specificity of 59.7% (95% CI 53.2, 66.2%). Only older age was significantly associated with misdiagnosis of comorbid mental disorders by PHC (adjusted odds ratio, 95% CI = 1.06, 1.02 to 1.11). Conclusion Routine detection of co-morbid mental disorder in people with epilepsy was very low. Combining clinical judgement with use of a screening scale holds promise but needs further evaluation.

show abstract

“…The total mean score ranges from 0-100 with a higher score indicating better quality of life. For this study, the instrument was adapted and construct validity was established (30).…”

Section: Primary Outcome (T 0 and T 1 )mentioning

confidence: 99%

Impact of co-morbid common mental disorder symptoms in people with epilepsy in Ethiopia on quality of life and functional disability: a cohort study

Tsigebrhan,

Medhin,

Belina

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background There is very limited prospective evidence on the impact of co-morbid mental health conditions in people with epilepsy living in low and middle-income countries. The objective of this study was to investigate the impact of common mental disorder (CMD; depression/anxiety) symptoms and risky substance use in people with epilepsy in Ethiopia on quality of life and functioning over six months. Methods A prospective cohort study of people with epilepsy was carried out in four districts of south-central Ethiopia. Comorbid CMD symptoms, risky substance uses (exposures) and the primary outcome, quality of life (QoL) was measured at baseline and 6 months follow-up. Secondary outcomes functional disability and seizure frequency were measured at follow-up. Multivariable linear regression was employed to evaluate whether comorbid CMD symptoms predicted a change in QoL and functional disability. Structural equation modelling (SEM) was employed to examine direct and indirect pathways linking co-morbid CMD symptoms with QoL or functional disability. Results In the multivariable regression model, neither CMD symptoms (β coef= -0.37, 95%CI -1.30, + 0.55) nor moderate to high risk of alcohol use (β= -0.70, 95% CI -9.20, + 7.81) were significantly associated with a change in QoL, and there was no effect modification by treatment engagement. In SEM, QoL at 6 months was significantly predicted by seizure frequency. The summative effect of CMD on QoL was significant (B= -0.27, 95%CI -0.48, -0.056), although direct and indirect associations were non-significant. Change in functional disability was not significantly associated with baseline CMD symptoms (β coef.= -0.03, 95% CI-0.48,+0.54) or with moderate to high risk of alcohol use (β coef.= -1.31, 95% CI -5.89, 3.26). However, in the SEM model, functional disability at 6 months was predicted by both baseline CMD symptoms (B = 0.24, 95% CI 0.06, 0.41) and seizure frequency (B = 0.67, 95% CI 0.46, 0.87). Conclusions In this rural Ethiopian setting, co-morbid CMD symptoms and seizure frequency in PWE independently predicted functional disability in people with epilepsy. The association between CMD symptoms and QoL was less conclusive. Integrated management of mental health and neurological conditions is needed to better address the psychosocial needs and improved functioning of people with epilepsy.

show abstract

Comorbid mental disorders and quality of life of people with epilepsy attending primary health care clinics in rural Ethiopia

Cited by 10 publications

References 45 publications

Anti-seizure medications and quality of life in person with epilepsy

Anti-seizure medications and quality of life in person with epilepsy

Performance of primary health care workers in detection of mental disorders comorbid with epilepsy in rural Ethiopia

Impact of co-morbid common mental disorder symptoms in people with epilepsy in Ethiopia on quality of life and functional disability: a cohort study

Contact Info

Product

Resources

About