Depression among people with epilepsy in Northwest Ethiopia: a cross-sectional institution based study

Abstract

BackgroundEpilepsy is the world’s most common neurological disorder, affecting approximately 50 million people worldwide and contributed to different psychiatric illness. Depression is one of the most frequent co morbid psychiatric disorders that affects the life of the patients’. This study aimed to assess the prevalence of depression and associated factors among epileptic patients attending the outpatient department of the University of Gondar Hospital, Northwest Ethiopia, 2014.MethodsInstitution based quantitative cross—sectional study was conducted among 405 individual with epilepsy. The participants were selected using systematic random sampling technique. Semistructured questionnaires were used to obtain socio-demographic and clinical data. Depression was measured using Beck’s Depression Inventory Binary logistic regression used for analysis.ResultsThe estimated, prevalence of depression was found to be 45.2 %. Out of these (29.6 %) were classified as mild, (14.8 %) as moderate and (0.8 %) were severely depressed. A lower educational status was associated with an increased prevalence of depression and the adjusted odds ratio (AOR) for the illiterate [can’t read and write] was 8.32 [95 % Confidence Interval (CI): 4.83, 14.29]. Perceived stress (AOR = 6.21, CI 3.69, 10.44), onset of illness <6 years (AOR = 5.29, CI 4.09, 15.89), seizure frequency of [1–11 per year (AOR = 1.34, CI 1.41, 4.36), ≥1 per month (AOR = 7.83, CI 3.52, 17.40)], poly-pharmacy (AOR = 7.63, CI 2.74, 21.26)] and difficulties of adherence to antiepileptic drugs (AOR = 4.80, CI 2.57, 8.96) were also found to be independently associated with depression.ConclusionOverall, the prevalence of depression was found to be high. Lower educational status, early onset of illness, seizure frequency, poly-pharmacy and difficulties of adherence to anti-epileptic drugs (AEDs) were factors statistically associated with depression. Strengthening the educational status of the patients on the effect of early onset of the illness, frequent seizure occurrence and difficulty of adherence to AEDs as a contributing factors for other co-morbid psychiatric disorder are suggested in the clinical care setting.

Prevalence and risk factors of depression and anxiety among patients with convulsive epilepsy in rural West China

“…19 One explanation might be the method of diagnosis, which may lead to different reported occur- Most studies show that individuals with a lower level of education are more likely to suffer from anxiety and depression. 6,23 However, this study fails to support the association between education, depression, and anxiety. This may result from the small number of highly educated patients in this population, thereby not providing enough power to demonstrate any differences.…”

Help seeking and suicidality among people with epilepsy in a rural low income country setting: cross-sectional survey

“…The prevalence of depression among PWE in this resource limited setting using the primary care validated cut-off (70.8%) was also higher than the general population depression prevalence (28.8%) using the same validated cut-off (5 or more) [38]. This prevalence of depression was also higher than the prevalence that is reported in the institution based studies from Ethiopia [7–9]. Various explanations have been proposed to explain the elevated levels of depression in epilepsy; (1) underlying structural brain disease, (2) damage related to uncontrolled seizures, and (3) psychosocial impact of the stigma and disability associated with epilepsy [6].…”

“…Hospital based studies conducted in Ethiopia have shown that the prevalence of depression is high among people with epilepsy [7–9]. Comorbid psychiatric disorders, such as depression, have a substantial negative impact on quality of life [10–12] and are important risk factors for suicidal behaviours [13].…”

The comorbidity of epilepsy and depression: diagnosis and treatment

“…In 2015, Bifftu et al [57] conducted a cross-sectional study of 405 epileptics and found that patients who could not read and write, and those who had primary education and secondary education were 8 times, 6 times and 4 times more likely to have depression than those with college education, respectively.…”