Prevalence of psychiatric comorbidities among the patients of epilepsy attending general hospital psychiatric unit

Abstract

Background: Depression is most common psychiatric disorder in patients with epilepsy and it is the significant cause of morbidity. 1 Upto 50-60 percent of patients with epilepsy may develop psychiatric complications, particularly depression, anxiety, and psychotic disorders. 2 There is growing evidence of biological link between depression and epilepsy, and significant factors involved are the biological amines and gamma amino butyric acid (GABA) 3 along with other neurobiological and psychosocial factors. This study assess the symptoms and severity of psychiatric comorbidities in patients diagnosed with epilepsy. Methods and Findings: This study was conducted on patients attending psychiatric outpatient epilepsy clinic in psychiatry department, government medical college, Amritsar. A total of 40 patients were studied to find out the prevalence and severity of depression by using self applicable questionnaire, Beck depression inventory (BDI), 4 and MINI, in patients who are diagnosed with epilepsy by clinical interview and examination by senior psychiatrist consultant. In the results of our study 50% patients had psychiatric co-morbidities.40% had depressive disorder. Depression is found to be more among females in our study. 22.5 % were females and 17.5% were males. Among depressed patients, 22.5% had severe depression. Prevalence of moderate depression was 15% , and 2.5 % had borderline clinical depression, 5% had psychosis, and 5% had substance dependence. Conclusion: Diagnosing psychiatric co-morbidities can be difficult in patients with epilepsy. The treatment of both epilepsy and depression need for close collaboration. Patient taking antiepileptic medication may have symptoms of depression as a result of their treatment. Sadly, data from drug trials are often helpful. The antiepileptic medications most closely associated with acute depression on initiation of treatment are vigabatrin, phenobarbitone, and topiramate. Depression with topiramate may be due to abrupt cessation of seizures or drug toxicity. Patients starting tiagabine may develop symptoms of agitation, withdrawal, and mood disturbance suggestive of depression;. Thus good awareness and recognition of psychiatric conditions can help a long way in improving the quality of care of patients with epilepsy.

Common mental illness among epilepsy patients in Bahir Dar city, Ethiopia: A cross-sectional study

“…The magnitude of common mental disorders in the current study is in line with the findings done in Mexico [24] (36.4%) and in India (32.5%) [25,26]. However, this study has revealed much lower magnitude of comorbidity of common mental illness than the result done in Zambia (53.7%) [27], Brazil (54.1%) [28], India (50.0%) [29], and Turkey(40.5%) [30]. The higher prevalence in Zambia and Brazil might be because of differences in inclusion criteria and instrument variation for screening mental illness.…”

Prevalence and associated factors of depression among people with epilepsy in Ethiopia: a cross-sectional study

“…A hospital-based cross-sectional study conducted in the northeastern part of India prevailed that 18% of PWE experiences depression and the Presence of partial seizures, frequent seizures, long duration of epilepsy and poor compliance to the antiepileptic drug were significantly associated with depression [19]. Another institutional-based cross-sectional study conducted on patients attending psychiatric outpatient epilepsy clinic in the psychiatry department of Amritsar city in India shows that 40% of the participant suffers from depression (with 22.5% severe depression and 17.5% moderate depression) and also being female and on antiepileptic medication also factors associated with depression [20].…”

Prevalence and associated factors of anxiety disorder symptoms among people with epilepsy in Mekelle, Ethiopia, 2019: Institutional‐based cross‐sectional study

“…A cross‐sectional study conducted in Canada among PWE to determine the magnitude and associated factors of anxiety found that the prevalence of anxiety was 40.0%, having depression, medication side effects, smoking and illicit substance use were significantly associated with anxiety (Pham et al., 2017). A study conducted in India among PWE shows that 50% of the study participants develop psychiatric comorbidity (Rani et al., 2018). A case–control study conducted in India reported that PWE had higher anxiety of 32.5% as compared with asthmatic patient control (17.5%) and normal control (7.5%), had longer duration of seizures, had increased frequency of seizures, had recent reappearance of seizures, had anti‐convulsant polypharmacy, had poor compliance with medications, and family history of seizures is an independent predictive factor (Amruth et al., 2014).…”