Prevalence of depression and associated factors among epileptic patients at Ilu Ababore zone hospitals, South West Ethiopia, 2017: a cross‑sectional study

Abstract

Background: Depression is one of the most common and overwhelming mental disorder in patients with epilepsy. Despite its high prevalence, depression continues to be under-recognized and undertreated. This study aimed to assess the prevalence of depression and its associated factors among epileptic patients attending the outpatient department of Ilu Ababore zone hospitals, Southwest Ethiopia, 2017. Methods: Institution-based cross-sectional study was carried out among 402 individual with epilepsy. The participants were selected using systematic random sampling technique. Depression was measured using Beck's Depression Inventory II. Oslo 3 Social Support Scale was used to assess social support. Perceived Stress Scale was used to assess the stress level of epileptic patients. The data were entered into Epi Info version 7 and analyzed by the SPSS version 20 software. We computed bivariate and multivariate binary logistic regressions to assess factors associated with depression. Statistical significance was declared at p-value < 0.05. Results: A total of 402 study participants were interviewed with a response rate of 96.2%. The prevalence of depression was found to be 48.1%. In the final multivariate analysis, educational status [unable to read and write (AOR = 4.01,95% CI = 3.82, 8.28), primary (AOR = 3.43, 95% CI = 3.12,9.29), secondary (AOR = 2.01, 95% CI = 1.89,7.24)], high perceived stress (AOR = 3.21, 95% CI = 2.70, 8.41), poor social support (AOR = 2.04, 95% CI = 1.42, 2.78), onset of illness < 6 year (AOR = 2.40, 95%CI = 2.10,7.91), seizure frequency of [1-11 per year (AOR = 2.34, 95% = 1.41, 4.36), ≥ 12/year (AOR = 3.49, 95% CI = 3.43, 6.40)], and polytherapy (AOR = 2.73, 95%CI = 2.52, 7.14) were independent predictors of depression among epileptic patients at p-value < 0.05. Conclusion and recommendation: Overall, the prevalence of depression was found to be high. Having lower educational status, early onset of illness, poor social support, high perceived stress, high seizure frequency, and polytherapy were factors statistically associated with depression. Clinicians need to give emphasis to epileptic patients with high perceived stress, low educational status, and poor social support. An early depression-focused regular screening for epileptic patient should be carried out by trained health professionals. Linkage with mental health service providers also needs to be considered.

Treatment Outcome of Epileptic Patients Receiving Antiepileptic Drugs in Ethiopia: A Systematic Review and Meta-Analysis

“…Twentythree primary studies were included in the present systematic review and meta-analysis. These studies were conducted in different parts of Ethiopia (from Amhara seven primary articles [7,[13][14][15][16][17][18], Oromiya eight [8,9,[19][20][21][22][23][24], Addis Ababa four [25][26][27][28], Tigray two [9,29], and Southern Nation, Nationalities, and People two articles) [30,31]. The sample size of the included primary studies was considerably variable ranging from 121 to 415 participants.…”

“…Regarding the seizurefree period, two studies assessed seizure freedom over one month [6,21], one study over two months [17], two studies over three months [7,14,25], and the remaining studies assessed seizure freedom over at least six months. Concerning the age groups, one study included only pediatric patients [7], two studies included all age group patients [13,19], and the remaining studies included only adult patients [6,8,9,[14][15][16][17][18][20][21][22][23][24][25][26][27][28][29][30][31]. Regarding the antiepileptic drugs, most of the patients were treated with monotherapy and the commonly used drugs were phenobarbitone, phenytoin, carbamazepine, and valproic acid [6-8, 17, 20, 26].…”

Prevalence of depression and associated factors among patients with epilepsy at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019

“…Among the 50 million PWE worldwide, 9.5% to 85% are also likely to suffer from depressive disorders, and more than 80% of them reside in low-income regions where psychiatric comorbidity is often under recognized and undertreated [ 10 ].…”

“…Regarding its prevalence in Ethiopia 51.2 percent, 48.1 percent, 49.3 percent, at Benchimaji, Mettu and Jimma Hospital, respectively [ 10 , 12 , 13 ]. Similarly, in Amanuel Specialized Hospital, the instuition-based analysis using PHQ-9 was43.8 percent and HADS instruments were 43.8 percent and 32.8 percent [ 1 , 12 ].…”

“…Evidences from different literature indicate that level of education, frequency of seizure [ 10 , 14 ], income, marital status [ 10 ], residence [ 14 ], age [ 8 ], perceived stigma [ 14 ], onset of disease, number of drug [ 10 , 12 , 15 ], adverse drug event [ 16 ], comorbidity [ 4 ], drug frequency and social support [ 10 ] were associated with depression. Although a study was performed six years ago in this study area with a different instrument (BDI) that has 21 items based on detecting depression, including the normal population.…”