Engidaw Nigus Alemnew, Bacha Lemi, Kenea Adamu
1College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.
Department of Psychiatry, Faculty of Public Health and Medical Science, Mettu University, Mettu, Ethiopia.
Ann Gen Psychiatry. 2020 Mar 11;19:19. doi: 10.1186/s12991-020-00268-5. eCollection 2020.
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.
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 -value < 0.05.
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 -value < 0.05.
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.
抑郁症是癫痫患者中最常见且严重的精神障碍之一。尽管其患病率很高，但抑郁症仍未得到充分认识和治疗。本研究旨在评估2017年埃塞俄比亚西南部伊卢阿巴博尔地区医院门诊癫痫患者中抑郁症的患病率及其相关因素。
对402例癫痫患者进行基于机构的横断面研究。采用系统随机抽样技术选择参与者。使用贝克抑郁量表第二版测量抑郁。奥斯陆社会支持量表用于评估社会支持。感知压力量表用于评估癫痫患者的压力水平。数据录入Epi Info 7版本，并使用SPSS 20软件进行分析。我们计算了二元和多元二元逻辑回归，以评估与抑郁症相关的因素。当P值<0.05时具有统计学意义。
共访谈了402名研究参与者，应答率为96.2%。发现抑郁症患病率为48.1%。在最终的多变量分析中，教育程度[无法读写（优势比=4.01，95%置信区间=3.82，8.28）、小学（优势比=3.43，95%置信区间=3.12，9.29）、中学（优势比=2.01，95%置信区间=1.89，7.24）]、高感知压力（优势比=3.21，95%置信区间=2.70，8.41）、社会支持差（优势比=2.04，95%置信区间=1.42，2.78）、发病<6年（优势比=2.40，95%置信区间=2.10，7.91）、癫痫发作频率为[每年1 - 11次（优势比=2.34，95% =1.41，4.36）、≥12次/年（优势比=3.49，95%置信区间=3.43，6.40）]以及联合治疗（优势比=2.73，95%置信区间=2.52，7.14）是癫痫患者中抑郁症的独立预测因素，P值<0.05。
总体而言，发现抑郁症患病率很高。教育程度较低、疾病早发、社会支持差、感知压力高以及癫痫发作频率高和联合治疗是与抑郁症有统计学关联的因素。临床医生需要重视感知压力高、教育程度低和社会支持差的癫痫患者。应由经过培训的卫生专业人员对癫痫患者进行早期以抑郁症为重点的定期筛查。还需要考虑与心理健康服务提供者建立联系。
