Ernest Erneus, Fakih Zameer, Urio Obrey, Kisenge Rodrick
Department of Pediatrics and Child Health, Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania, United Republic of
Department of Pediatrics and Child Health, Muhimbili National Hospital, Dar es Salaam, Tanzania, United Republic of.
BMJ Open. 2025 Sep 18;15(9):e098286. doi: 10.1136/bmjopen-2024-098286.
This study aimed to assess the prevalence of depression and anxiety and to identify factors associated with these conditions among caregivers of children and adolescents with epilepsy attending the paediatric neurology clinic at Muhimbili National Hospital (MNH) in Tanzania.
A hospital-based cross-sectional study.
The paediatric neurology clinic of a national referral hospital in Dar es Salaam, Tanzania.
427 caregivers of children with epilepsy (CWE) were consecutively enrolled. Eligibility criteria included being 18 years or older and having provided care for the child for at least 6 months. Caregivers unable to read and write in Swahili or previously diagnosed with a mental illness before assuming the caregiving role were excluded.
Primary outcomes were the prevalence of depression (assessed with the Patient Health Questionnaire-9 (PHQ-9), cut-off ≥10), anxiety (assessed with the Generalised Anxiety Disorder-7 tool (GAD-7), cut-off ≥10), and their co-occurrence. Secondary outcomes were the factors associated with these conditions, analysed using logistic regression and reported as adjusted odds ratios (aORs).
Depression was observed in 74 (17.3%, 95% CI: 13.8 to 21.3) participants and anxiety was found in 74 caregivers (17.3%,95% CI: 14.1 to 20.8). 38 (9.0%, 95% CI: 6.3 to 11.7) participants had concurrent depression and anxiety. Factors associated with depression were having a child: less than 5 years old (adjusted OR (aOR)=6.56, p=0.012), epilepsy duration of more than 5 years (aOR=2.80, p=0.048), history of epilepsy-related injuries (aOR=2.64, p=0.015) and three or more admissions (aOR=2.56, p=0.046). Caregivers whose children had not started school or were in primary school had lower odds of depression compared with counterparts in secondary school (aOR=0.02, p=0.003) and (aOR=0.03, p=0.005), respectively. Caregivers' anxiety was associated with having a child with: another comorbidity (aOR=1.93, p=0.020), a history of epilepsy-related injuries (aOR=2.37, p=0.030), three or more admissions (aOR=2.98, p=0.015) and caregiver age between 41 to 50 years (aOR=3.06, p=0.042).
Depression and anxiety are prevalent among caregivers of CWE. The findings indicate a need for the integration of mental health services within paediatric neurology clinics to support caregiver well-being.
本研究旨在评估坦桑尼亚姆希比利国家医院（MNH）儿科神经科门诊中癫痫患儿及青少年的照料者中抑郁症和焦虑症的患病率，并确定与这些状况相关的因素。
一项基于医院的横断面研究。
坦桑尼亚达累斯萨拉姆一家国家级转诊医院的儿科神经科门诊。
连续纳入427名癫痫患儿（CWE）的照料者。纳入标准包括年龄在18岁及以上，且已照料该患儿至少6个月。无法用斯瓦希里语读写或在承担照料角色之前曾被诊断患有精神疾病的照料者被排除。
主要结局为抑郁症患病率（采用患者健康问卷-9（PHQ-9）评估，临界值≥10）、焦虑症患病率（采用广泛性焦虑障碍-7工具（GAD-7）评估，临界值≥10）及其共病情况。次要结局为与这些状况相关的因素，采用逻辑回归分析并报告为调整比值比（aORs）。
74名参与者（17.3%，95%置信区间：13.8%至21.3%）存在抑郁症，74名照料者（17.3%，95%置信区间：14.1%至20.8%）存在焦虑症。38名参与者（9.0%，95%置信区间：6.3%至11.7%）同时患有抑郁症和焦虑症。与抑郁症相关的因素包括：孩子年龄小于5岁（调整后比值比（aOR）=6.56，p=0.012）、癫痫病程超过5年（aOR=2.80，p=0.048）、有癫痫相关损伤史（aOR=2.64，p=0.015）以及三次或更多次住院（aOR=2.56，p=0.046）。孩子未上学或就读小学的照料者与就读中学的照料者相比，患抑郁症的几率较低，分别为（aOR=0.02，p=0.003）和（aOR=0.03，p=0.005）。照料者的焦虑症与孩子患有：另一种合并症（aOR=1.93，p=0.020）、有癫痫相关损伤史（aOR=2.37，p=0.030）、三次或更多次住院（aOR=2.98，p=0.015）以及照料者年龄在41至50岁之间（aOR=3.06，p=0.042）相关。
癫痫患儿照料者中抑郁症和焦虑症普遍存在。研究结果表明需要在儿科神经科门诊中整合心理健康服务，以支持照料者的健康。
