Prevalence, severity, and associations of depression in people with epilepsy in Guinea: A single-center study

Sylla, Mariame; Vogel, Andre C.; Bah, Aissatou Kenda; Tassiou, Nana Rahamatou; Barry, Souleymane; Djibo, Bachir A.; Touré, Mohamed Lamine; Foksona, Sakadi; Konaté, Mamady; Cisse, Fodé Abass; Mateen, Farrah J.

doi:10.1016/j.yebeh.2020.107475

Cited by 8 publications

(10 citation statements)

References 45 publications

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“…Among those who reported at least mild depression symptoms at baseline, full remission was achieved by 40%, 50%, and 54% of participants at three, six, and 12 months, respectively. Mild depression was the most frequent depressive severity among those with depression at all time points, which is consistent with prior literature assessing depression severity in primarily adult women in Sub-Saharan Africa [ 22 , 48 , 49 ].…”

Section: Discussionsupporting

confidence: 89%

The longitudinal association of stressful life events with depression remission among SHARP trial participants with depression and hypertension or diabetes in Malawi

Landrum,

Gaynes,

Akello

et al. 2024

PLoS ONE

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Depressive disorders are leading contributors to morbidity in low- and middle-income countries and are particularly prevalent among people with non-communicable diseases (NCD). Stressful life events (SLEs) are risk factors for, and can help identify those at risk of, severe depressive illness requiring more aggressive treatment. Yet, research on the impact of SLEs on the trajectory of depressive symptoms among NCD patients indicated for depression treatment is lacking, especially in low resource settings. This study aims to estimate the longitudinal association of SLEs at baseline with depression remission achievement at three, six, and 12 months among adults with either hypertension or diabetes and comorbid depression identified as being eligible for depression treatment. Participants were recruited from 10 NCD clinics in Malawi from May 2019-December 2021. SLEs were measured by the Life Events Survey and depression remission was defined as achieving a Patient Health Questionaire-9 (PHQ-9) score <5 at follow-up. The study population (n = 737) consisted predominately of females aged 50 or higher with primary education and current employment. At baseline, participants reported a mean of 3.5 SLEs in the prior three months with 90% reporting ≥1 SLE. After adjustment, each additional SLE was associated with a lower probability of achieving depression remission at three months (cumulative incidence ratio (CIR) 0.94; 95% confidence interval: 0.90, 0.98, p = 0.002), six months (0.95; 0.92, 0.98, p = 0.002) and 12 months (0.96; 0.94, 0.99, p = 0.011). Re-expressed per 3-unit change, the probability of achieving depression remission at three, six, and 12 months was 0.82, 0.86, and 0.89 times lower per 3 SLEs (the median number of SLEs). Among NCD patients identified as eligible for depression treatment, recent SLEs at baseline were associated with lower probability of achieving depression remission at three, six, and 12 months. Findings suggest that interventions addressing SLEs during integrated NCD and depression care interventions (e.g., teaching and practicing SLE coping strategies) may improve success of depression treatment among adult patient populations in low-resource settings and may help identify those at risk of severe and treatment resistant depression.

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Section: Discussionsupporting

confidence: 89%

The longitudinal association of stressful life events with depression remission among SHARP trial participants with depression and hypertension or diabetes in Malawi

Landrum,

Gaynes,

Akello

et al. 2024

PLoS ONE

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“…The study on Korean university students has also found good convergent validity of PHQ-9 with GAD-7, with a correlation coefficient of 0.68 [ 92 ]. Other studies have also found strong evidence of convergent validity of PHQ-9 with similar psychometric instruments in different settings [ 29 , 31 , 47 , 93 – 98 ]. Together, these findings suggest the reliability and validity of applying the PHQ-9 scale as a measure of symptoms of depression in the context of university students in different countries.…”

Section: Discussionmentioning

confidence: 83%

Validity and reliability of the Patient Health Questionnaire scale (PHQ-9) among university students of Bangladesh

et al. 2022

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This study investigated the reliability and factorial validity of Patient Health Questionnaire-9 (PHQ-9) in the context of university students in Bangladesh. The research aimed to assess whether the original one-dimensional model or a model containing both somatic and cognitive-emotional factors is appropriate in the case of a sample of university students. A repeated cross-sectional survey design based on convenience sampling was used to collect data from 677 university students from both public and private universities. The factor structure of the PHQ-9 was assessed using confirmatory factor analysis (CFA). Measurement invariances were assessed across gender, type of university, level of education and victim of domestic violence. Its convergent validity was determined by investigating its correlations with Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS). Results showed excellent reliability of PHQ-9 as measured by both Cronbach’s α and McDonald’s ω. CFA suggested that a modified one-factor model where the error variances between item-3 (‘sleeping difficulties’) and item-6 (‘feeling as a failure’), item-6 and item-9 (‘suicidal thoughts’), item-4 (‘feeling tired’) and item-9, item-3 and item-9 were allowed to covary is appropriate for the sample. This model provided high values of comparative fit index (CFI), goodness of fit index (GFI), and Tucker Lewis Index (TLI), low value of standardized root mean square residual (SRMR) and a non-significant root mean square error of approximation (RMSEA) as well as a high Factor Determinacy Score Coefficient. Correlation between PHQ-9 and GAD-7 was 0.751 and 0.934 between PHQ-9 and PHQ-ADS. Finally, the model is strictly invariant across gender and university type. Overall, the study provided support for modified unidimensional structure for PHQ-9 and showed high internal consistency along with good convergent validity.

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“…The average seizure frequency over the 30 days prior to follow up was 1.5 (95%CI [0.5, 2.6]) and significantly lower than at baseline (p = 0.002). 66% of participants were No to mild depressive symptoms (0-9 points), moderate (10)(11)(12)(13)(14)(15)(16)(17)(18)(19), severe (20)(21)(22)(23)(24)(25)(26)(27) No to mild anxious symptoms (0-4 points), moderate (5)(6)(7)(8)(9)(10)(11)(12)(13)(14), severe (15)(16)(17)(18)(19)(20)(21) F I G U R E 2 Distribution of scores on the PHQ-9 (a) and GAD-7 (b) at baseline and 90-day follow up.…”

Section: -Day Follow-up Visitmentioning

confidence: 99%

“…In the Republic of Guinea, a low-income country in West Africa, ranked 182 of 191 countries on the United Nations Human Development Index [8], one third of PLWE over 12 years old endorsed symptoms of anxiety and two thirds had depressive symptoms [9]. Drug affordability remains a major concern in Guinea as many PLWE have no personal incomes and drop out of school or work due to seizures, exacerbating a cycle of poverty with disease.…”

Section: Introductionmentioning

confidence: 99%

“…Left untreated or undertreated, epilepsy is highly linked to mental health disorders as well as unintentional injury, sudden death, and high self‐perception of stigma [1, 10–12]. In Guinea, 25% of PLWE who sought ASM treatment endorsed thoughts of suicide or self‐harm in our prior work [9], a high proportion in what is largely considered a treatable brain disorder and a concerning statistic given epilepsy healthcare providers in Sub‐Saharan Africa screen for mental health disorders infrequently (14% of newly diagnosed PLWE) and only 16% report high levels of confidence in competently managing psychiatric comorbidities [13].…”

Section: Introductionmentioning

confidence: 99%

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Impact of a free medication intervention on seizure recurrence and anxious and depressive symptoms in people living with epilepsy in the Republic of Guinea

Rice,

Guelngar,

Traoré

et al. 2023

Tropical Med Int Health

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Background and ObjectiveOf ~5 million people living with epilepsy (PLWE) in Sub‐Saharan Africa, roughly one‐third experience depression and over one third experience anxiety. In Guinea, these issues may be compounded by fewer available resources, such as appropriate anti‐seizure medications (ASMs). We aim to quantify seizure frequency, anxiety and depression in PLWE in Guinea, before and after a free ASM intervention and neurologist's consultation.MethodsGuinean participants >12 years old with ≥2 unprovoked seizure were prospectively recruited. As part of a broader interview, participants reported prior 30‐day seizure frequency and screened for depression (PHQ‐9) (range 0–27 points) and anxiety (GAD‐7) (range 0–21 points) with re‐evaluation at 90 days.ResultsOf 148 participants enrolled (mean age = 27.3 years, range 12–72; 45% female), 62% were currently taking ASMs. For the 30 days pre‐enrolment, average seizure frequency was 3.2 (95%CI 2.3, 4.2); 28% of participants were seizure‐free. ASM regimens were modified for 95% of participants, mostly initiating levetiracetam (n = 115, 80% of modifications). 90‐day study retention was 76% (n = 113) among whom 87% reported full adherence to the ASM. After 90 days, the average seizure frequency over the prior 30 days was 1.5 (95%CI 0.5, 2.6), significantly lower than at baseline (p = 0.002). 66% were seizure‐free.At baseline, average PHQ‐9 score was 21.2 (95%CI [20.2, 22.2]), indicating severe depressive symptoms. Average GAD‐7 score was 16.5 [15.6, 17.4], indicating severe anxious symptoms. At 90‐days, average PHQ‐9 score was 17.5[16.4, 18.5] and significantly lower than baseline (p < 0.001). Average GAD‐7 score was 14.4 [13.6, 15.3] and significantly lower than baseline (p = 0.002). Seizure frequency was not correlated with PHQ‐9 nor GAD‐7 scores at baseline but was at 90 days for both PHQ‐9 (r = 0.24, p = 0.01) and GAD‐7 (r = 0.22, p = 0.02) scores. The prevalence of suicidal ideation dropped from 67% to 47% of participants (p = 0.004).DiscussionASM management has dual importance for PLWE in resource‐limited settings, improving both seizure control and mental health.

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Prevalence, severity, and associations of depression in people with epilepsy in Guinea: A single-center study

Cited by 8 publications

References 45 publications

The longitudinal association of stressful life events with depression remission among SHARP trial participants with depression and hypertension or diabetes in Malawi

The longitudinal association of stressful life events with depression remission among SHARP trial participants with depression and hypertension or diabetes in Malawi

Validity and reliability of the Patient Health Questionnaire scale (PHQ-9) among university students of Bangladesh

Impact of a free medication intervention on seizure recurrence and anxious and depressive symptoms in people living with epilepsy in the Republic of Guinea

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