Correlates of psychological distress in epileptic patients during the COVID-19 outbreak

Giordano, Alfonso; Siciliano, Mattia; Sant'Elia, Valeria; Russo, Antonio; Tedeschi, Gioacchino; Tessitore, Alessandro

doi:10.1016/j.yebeh.2020.107632

Cited by 14 publications

(29 citation statements)

References 24 publications

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“…We combined survey responses from Sao Paulo and Rio de Janeiro, the two states with the highest number of cases and deaths, to the rest of Brazil. Similar to previous studies, our results suggest that the effects of COVID-19 in people with epilepsy and their caregivers are not directly related to infection case number or mortality [16] , [17] , [21] . Instead, the reported impact on health and wellbeing more likely reflects individual experiences of public health measures and countrywide changes in healthcare such as resource reallocation, change to telemedicine, and alternative arrangements for obtaining ASM prescriptions.…”

Section: Discussionsupporting

confidence: 90%

“…People with epilepsy are, overall, not considered to be at greater risk of COVID-19 infection or of developing a more severe form of the disease [12] , [13] , [14] , [15] , [16] , [17] , [18] . Other factors, including difficulty obtaining antiseizure medications (ASMs) and problems in accessing the health system, may play a role in worsening seizure control and exacerbating comorbidities in this group [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] .…”

Section: Introductionmentioning

confidence: 99%

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Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study

Andraus

Thorpe

Tai

et al. 2021

Epilepsy & Behavior

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The COVID-19 pandemic has had an unprecedented impact on people and healthcare services. The disruption to chronic illnesses, such as epilepsy, may relate to several factors ranging from direct infection to secondary effects from healthcare reorganization and social distancing measures. Objectives As part of the COVID-19 and Epilepsy (COV-E) global study, we ascertained the effects of COVID-19 on people with epilepsy in Brazil, based on their perspectives and those of their caregivers. We also evaluated the impact of COVID-19 on the care delivered to people with epilepsy by healthcare workers. Methods We designed separate online surveys for people with epilepsy and their caregivers. A further survey for healthcare workers contained additional assessments of changes to working patterns, productivity, and concerns for those with epilepsy under their care. The Brazilian arm of COV-E initially collected data from May to November 2020 during the country's first wave. We also examined national data to identify the Brazilian states with the highest COVID-19 incidence and related mortality. Lastly, we applied this geographic grouping to our data to explore whether local disease burden played a direct role in difficulties faced by people with epilepsy. Results Two hundred and forty-one people returned the survey, 20% were individuals with epilepsy ( n = 48); 22% were caregivers ( n = 53), and 58% were healthcare workers ( n = 140). Just under half (43%) of people with epilepsy reported health changes during the pandemic, including worsening seizure control, with specific issues related to stress and impaired mental health. Of respondents prescribed antiseizure medication, 11% reported difficulty taking medication on time due to problems acquiring prescriptions and delayed or canceled medical appointments. Only a small proportion of respondents reported discussing significant epilepsy-related risks in the previous 12 months. Analysis of national COVID-19 data showed a higher disease burden in the states of Sao Paulo and Rio de Janeiro compared to Brazil as a whole. There were, however, no geographic differences observed in survey responses despite variability in the incidence of COVID-19. Conclusion Our findings suggest that Brazilians with epilepsy have been adversely affected by COVID-19 by factors beyond infection or mortality. Mental health issues and the importance of optimal communication are critical during these difficult times. Healthcare services need to find nuanced approaches and learn from shared international experiences to provide optimal care for people with epilepsy as the direct burden of COVID-19 improves in some countries. In contrast, others face resurgent waves of the pandemic.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study

Andraus

Thorpe

Tai

et al. 2021

Epilepsy & Behavior

View full text Add to dashboard Cite

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“…In seven studies, depression was measured via polarization score [18], such as Beck depression inventory scale II (BDI-Ⅱ) [19], 9-item Patient Health Questionnaire (PHQ-9) [6,15], Hospital Anxiety and Depression Scale (HADS) [6,20], a 19-item questionnaire [4], and a survey [21]. We used the PHQ-9 scale to measure the symptoms of depression.…”

Section: The Effect Of Covid-19 Pandemic On the Depression Of People With Epilepsymentioning

confidence: 99%

Prevalence of depression, anxiety, and psychological distress in patients with epilepsy during COVID-19: A systematic review

Tashakori-Miyanroudi

Souresrafil

Hashemi

et al. 2021

Epilepsy & Behavior

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“…These patients were older, had more frequently severe epilepsy, difficulties with prescription renewals and ASM dispensing, especially in the Brazilian public healthcare system. Seizure worsening was reported in other studies during the pandemic, which ranged from 4-35% of the surveyed population [11,20,23,[25][26][27]29,[30][31][32]. Physical and psychological concerns including beliefs of higher risk of having COVID-19, with new onset use of antidepressants and financial problems were also related to seizure worsening.…”

Section: Discussionmentioning

confidence: 60%

COVID-19 and epilepsy: How are people with epilepsy in Brazil?

Guilhoto

Mosini

Susemihl³

et al. 2021

Epilepsy & Behavior

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During COVID-19 pandemic the global population is facing an important psychosocial distress. The aim of this study was to evaluate how people with epilepsy (PWE) in Brazil is dealing with the pandemic, in relation to seizure frequency, access to antiseizure medicines (ASM), medical follow-up, and well-being. Methods: An online questionnaire survey among PWE (group 1) and caregivers (group 2) was applied in the social networks of the Brazilian Association of Epilepsy, the official Brazilian chapter of the International Bureau for Epilepsy. The questionnaire was composed of 46 generic questions in four areas, namely, demographics and baseline clinical data as well as epilepsy and quality-of-life impact by COVID-19 pandemic based on the domains of the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) instrument. Results: The questionnaire was answered by 464 participants including 380 (81.9%) PWE (78.7% female; age 34.3 yrs.; ±9.76) and 84 (18.1%) caregivers (patients' age 14.1 yrs.; ±10.30). During the COVID-19 pandemic, 36.8% of PWE and 36.4% of caregivers reported difficulties in accessing the epilepsy healthcare provider, and visits occurred normally only in 29.7% of PWE and in 34.5% of the caregiveŕs group. Telehealth was not provided for 66.6% of group 1 and for 58.5% of group 2. Lack of availability of ASM was reported by 21.9% of PWE and 28.0% of caregivers in public dispensing units and by 19.2% and 17.8%, respectively, in private pharmacies. Increase in seizures during pandemic was mentioned by 26.3% and 27.9% of groups 1 and 2, respectively. Patients who had increase in seizure frequency had more frequently reported problems with treatment and in quality-of-life concepts. Fear of having a more severe COVID-19 presentation because of epilepsy was reported by 74.5% of PWE and by 89.8% of caregivers. Dissatisfaction with current health status was reported by 36.7% and 38.1% in groups 1 and 2, respectively, and that the support from others has decreased (56.1% and 66.1%, in groups 1 and 2) during the pandemic. The factors with higher Odds Ratio of increase in seizure frequency during pandemic were age >41 yrs., treatment in public healthcare system, drug-resistant epilepsy, adversities in getting ASM in public dispensing units, difficulties with prescription renewals, current financial problems and belief that epilepsy or ASM are risk factors for contracting COVID-19. Conclusion: During COVID-19 pandemic in Brazil, PWE and caregivers reported increase in seizures in one-fourth of the patients and several difficulties, namely problems in accessing the healthcare system including ASM dispensation, telehealth, and fear of having a more severe COVID-19 because of epilepsy. There were also physical, psychological, and social concerns which affected quality-of-life-related aspects in this population. These facts may increase treatment gap in epilepsy in Brazil as well in other developing countries.

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Correlates of psychological distress in epileptic patients during the COVID-19 outbreak

Cited by 14 publications

References 24 publications

Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study

Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study

Prevalence of depression, anxiety, and psychological distress in patients with epilepsy during COVID-19: A systematic review

COVID-19 and epilepsy: How are people with epilepsy in Brazil?

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