Determinants of depression among people with epilepsy in Central Ethiopia

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Abstract

Background

Depression is the most frequently and highly occurring mental disorders in epilepsy patients. When depression is comorbid with epilepsy, it leads to low employment and poor quality of life. Thus, the aim of this study was to assess the prevalence and associated factors of depression among people living with epilepsy in Central Ethiopia.

Methods

Institution-based cross-sectional study was conducted from April to May 2015 at Amanuel Mental Specialized and TikurAnbesa Hospitals, Addis Ababa, Ethiopia. Samples of 422 epilepsy patients were selected, and data on depression were collected using validated questionnaire using face-to-face interview technique. Logistic regression analysis was performed to assess predictors of depression.

Results

The study indicated that the prevalence of depression among people with epilepsy was 43.8%. Factors associated with depression were being female (AOR 2.48; 95% CI, 1.61.3.81), being single (AOR 2.23; 95% CI 1.38–3.60), perceived stigma (AOR 2.47; 95% CI 1.59–3.83), medication adherence (AOR 2.85; 95% CI 1.64–4.96), and current substance use (AOR 2.10; 95% CI 1.34–3.30).

Conclusion

There is a high prevalence of depression among epilepsy patients. Early detection and prompt management of depressive symptoms are critically important in reducing depression burden among people living with epilepsy.

Related collections

Most cited references 19

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Validity of the Patient Health Questionnaire-9 for depression screening and diagnosis in East Africa.

Bizu Gelaye, Michelle Williams, Seblewengel Lemma … (2013)

Depression is often underdiagnosed and undertreated in primary care settings, particularly in developing countries. This is, in part, due to challenges resulting from lack of skilled mental health workers, stigma associated with mental illness, and lack of cross-culturally validated screening instruments. We conducted this study to evaluate the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) as a screen for diagnosing major depressive disorder among adults in Ethiopia, the second most populous country in sub-Saharan Africa. A total of 926 adults attending outpatient departments in a major referral hospital in Ethiopia participated in this study. We assessed criterion validity and performance characteristics against an independent, blinded, and psychiatrist administered semi-structured Schedules for Clinical Assessment in Neuropsychiatry (SCAN) interview. Overall, the PHQ-9 items showed good internal (Cronbach's alpha=0.81) and test re-test reliability (intraclass correlation coefficient=0.92). A factor analysis confirmed a one-factor structure. Receiver Operating Characteristics (ROC) analysis showed that a PHQ-9 threshold score of 10 offered optimal discriminatory power with respect to diagnosis of major depressive disorder via the clinical interview (sensitivity=86% and specificity=67%). The PHQ-9 appears to be a reliable and valid instrument that may be used to diagnose major depressive disorders among Ethiopian adults.

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Depression and epilepsy: epidemiologic and neurobiologic perspectives that may explain their high comorbid occurrence.

Andres Kanner, Steven Schachter, John J Barry … (2012)

Depression is the most frequent psychiatric comorbidity in people with epilepsy (PWE) with lifetime prevalence rates ranging between 30 and 35%. Multifactorial variables play a pathogenic role in the high comorbid occurrence of these two disorders. These variables were critically examined during an international symposium held in Chicago in September 2010, the results of which are presented in two companion manuscripts. The first manuscript summarizes new epidemiologic data highlighting the bidirectional relation between depression and epilepsy and related methodological issues in studying this relationship. An examination of the neurobiologic aspects of primary mood disorders, mood disorders in PWE and pathogenic mechanisms of epilepsy derived from studies in animal models and humans is allowing a better understanding of the complex relation between the two conditions. In the first manuscript, we review data from animal models of epilepsy in which equivalent symptoms of depression and anxiety disorders develop and, conversely, animal models of depression in which the kindling process is facilitated. Data from structural and functional neuroimaging studies in humans provide a further understanding of potential common pathogenic mechanisms operant in depression and epilepsy that may explain their high comorbidity. The negative impact of depression on the control of seizure disorders has been documented in various studies. In this manuscript, these data are reviewed and potential mechanisms explaining this phenomenon are proposed. Copyright © 2012 Elsevier Inc. All rights reserved.

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Depression and anxiety disorder among epileptic people at Amanuel Specialized Mental Hospital, Addis Ababa, Ethiopia

Minale Tegegne, Tilahun Belete Mossie, Andargie Abate Awoke … (2015)

Background Although depression and anxiety disorders are very common in people with epilepsy; there are no studies that assessed the magnitude and associated factors among epileptic people in Ethiopia. Therefore, this study determined prevalence and associated factors of depression and anxiety disorders in people with epilepsy. Method An institution based cross-sectional study was conducted from April to May, 2013, among 423 people with epilepsy from the outpatient department of Amanuel Mental Specialized Hospital. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale. Logistic regression analysis was used to assess predictors of depression and anxiety. Results The prevalence of anxiety and depression among epileptic people were 33.5 and 32.8 %, respectively. Monthly income, frequency of seizure and side effects of anti convulsants were found to be significantly associated with both depression and anxiety. Being divorced/widowed was associated with anxiety while using poly-therapy of anti convulsants, perceived stigma, and inability to read or write were associated with depression. Conclusion The prevalence of co-morbid anxiety and depression was found to be high among people with epilepsy. Early identification of co-morbid depression and anxiety in people with epilepsy and managing epilepsy to become seizure free should be of great concern for health care providers.

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Author and article information

Contributors

Asrat Chaka: asratchaka2016@yahoo.com

Tadesse Awoke: t_awoke@yahoo.com

Zegeye Yohannis: zegeyemaja@gmail.com

Getinet Ayano: ayanogetinet@yahoo.com

Minale Tareke: +251 913 395 731 , minale23@gmail.com

Andargie Abate: andargie_abate@yahoo.com

Mulugeta Nega: muleg2007@gmail.com

Journal

Journal ID (nlm-ta): Ann Gen Psychiatry

Journal ID (iso-abbrev): Ann Gen Psychiatry

Title: Annals of General Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1744-859X

Publication date (Electronic): 13 June 2018

Publication date PMC-release: 13 June 2018

Publication date Collection: 2018

Volume: 17

Electronic Location Identifier: 27

Affiliations

[1 ]Department of Psychiatry, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

[2 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Department of Epidemiology and Biostatistics, , University of Gondar, ; Gondar, Ethiopia

[3 ]ISNI 0000 0004 0439 5951, GRID grid.442845.b, College of Medicine and Health Science, , Bahir Dar University, ; Bahir Dar, Ethiopia

[4 ]ISNI 0000 0001 0108 7468, GRID grid.192267.9, College of Medicine and Health Science, , Haramaya University, ; Harer, Ethiopia

Article

Publisher ID: 197

DOI: 10.1186/s12991-018-0197-z

PMC ID: 5998556

SO-VID: 53de3685-d177-417d-b792-254b945b4786

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.