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Category: Volume 08 Issue 07 July 2020
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Title: Prevalence of Depression among Epilepsy Patients in a Tertiary Care Hospital of North-East Region

Authors: Dr Atul Debbarma, Dr Bappaditya Roy, Dr Siddhartha Debbarma

 DOI: https://dx.doi.org/10.18535/jmscr/v8i7.68

Abstract

Introduction: Epilepsy describes a condition in which a person has recurrent seizures due to chronic, underlying process. The definition implies that a person with a single seizure or recurrent seizures due to correctable or avoidable circumstances does not necessarily have epilepsy. Using the definition of epilepsy as two or more unprovoked seizures, the incidence of epilepsy is approximately 0.3 – 0. 5 % in different populations throughout the world and the prevalence of epilepsy has been estimated at 5 – 10 persons per 1000(1). Epilepsy is a common neurological disorder that affects populations worldwide and leads to severe personal, familial and social impact.

The word epilepsy is derived from Greek and means to “seize upon” or “taking hold of”. Epilepsy describes a condition in which a person has a tendency for recurrent, usually unprovoked seizures due to chronic, underlying process. One of the first descriptions of epileptic seizures can be traced back to 2000 years in ancient texts from Mesopotamia. Hippocrates studied the disease and disputed its divine origin in his classic treatise On The Sacred Disease.

Aim of the Study: This study aims to find out the prevalence of depression among epilepsy patients in a tertiary care hospital of north-east region.

Materials and Methods:  It was cross sectional study done on 100 patients attended to psychiatry OPD and referred from medicine OPD / IPD of AGMC & GBP Hospital, Agartala between January 2016 to December 2016.

Result: Out of these 100 epilepsy patient in the age group of 12 to 60 years shows 50 % were having depression. Moreover out of these 100 patients 29% had mild depression, 13% had moderate depression and 8% had severe depression. Most of the study subjects have the epilepsy since their ages between 12 to 28 years (39%) followed by 29 to 44 years (37%)

Most important this study shows out of these 100 patients male (54%) followed by female (46%). Surprisingly out of these 100 patients 37% were from upper middle class, 8% from lower middle class followed by 13% from upper lower class and 5% from upper class. Moreover 59% patients were married followed by unmarried 41%.

This study also reflect that 65% patients come from nuclear family followed by 35% from joint family. Ultimately the result of the study conclude that 41% patients had generalised tonic clonic seizure followed by followed by complex partial seizure (26 %) and absence seizure (24%). Simple partial seizure is 5% and partial seizure with secondary generalization is 4% and out of these 100 epileptic patient depression persist in 50 patient and among these 50 patients. Among 50 patients, depression in generalized tonic clonic seizure (20) is more than complex partial seizure (18) followed by absence seizure (7).

Discussion: In this study, data analysis revealed that the prevalence of depression among epileptic patients was 50% of all 100 epileptic subjects, divided between 29% have mild depression, 13% have moderate depression, and 8% have severe depression. The prevalence of depression among epileptic patients is variable in the previous studies, from as low as (9.5%) as shown in the study of Pooya & Sperlin(47), to as high as (61%) as shown in the study of Yousafzai et al.(44)

In my study finding about 50% of our patients had depression, in spite of high prevalence in comparison with some previous studies. Differences of the prevalence of depression may be because of methodological differences and may be due to associated socio-economic factors in our society.

References

  1. Standard Text Book of HARRISONS, Principles of INTERNAL MEDICINE 18th Edition, vol.no2, Chapter 369, page o.3251, Section 2 Diseases of the Central Nervous System.
  2. a. M. swinkels, J. Kuyk, r. van dyck, and p. spinhoven, “psychiatric co morbidity in epilepsy,” epilepsy & Behaviour, vol. 7, no. 1, pp. 37–50, 2005.
  3. J. Adams, t. J. O’Brien, J. Lloyd, c. J. Kilpatrick, M. r. salzberg, and  d. Velakoulis, neuropsychiatric morbidity in focal epilepsy,” the British Journal of psychiatry, vol. 192, no. 6,  pp. 464–469, 2008.
  4. sanchez-Gistau, l. pintor, G. sugranyes, et al., “Prevalence of interictal psychiatric disorders in patients with refractory temporal and extratemporal lobe epilepsy in spain.a comparative study,” epilepsia, vol. 51, no. 7, pp. 1309–1313, 2010.
  5. Seminario NA, Farias ST, Jorgensen J, Bourgeois JA, Seyal M. Determination of prevalence of depression in an epilepsy clinic using DSM-IV based self- report questionnaire. Epilepsy Behav 2009; 15:362-6.
  6. Kanner AM. Depression in epilepsy: A review of multiple facets of their close relation. Neurol Clin 2009; 27:865-80.
  7. Adewuya AO, Oseni SB. Impact of psychiatric morbidity on parent rated quality of life in Nigerian adolescents with epilepsy. Epilepsy Behav 2005; 7:497-501
  8. Kanner AM, Palac S. Depression in epilepsy: A common but often unrecognized co-morbid malady. Epilepsy Behav 2000; 1:37-51
  9. Okubadejo NU, Danesi MA, Aina OF, Ojini FI, Adeyemi JD, Olorunshola DA. Prospective case –control study of interictal depression and suicidal ideation in Nigerians with epilepsy. Niger Postgrad Med J 2007; 14:204-8.
  10. Boylan LS, Flint LA, Labovitz DL, Jackson SC, Starner K, Devinsky O. Depression but not epilepsy predicts quality of life in treatment resistant epilepsy. Neurology 2004; 62:258-61.
  11. Forsgren L, Nystrom L. An incident case referent study of epileptic seizures in adults. Epilepsy Res 1990; 6:66-81.
  12. Hesdorffer DC, Hauser WA, Annegers JF, Cascino G. Major depression is a risk factor for seizures in older adults. Ann Neurol 2000; 47:246-9.
  13. Study of Lowenstein DH, 1993.
  14. Study of Merlis 1974.
  15. Ahuja and Mahanta, 1982; Ramirez et al., 1984.
  16. Seminario NA, Farias ST, Jorgensen J, Bourgeois JA, Seyal M. Determination of prevalence of depression in an epilepsy clinic using DSM-IV based self- report questionnaire. Epilepsy Behav 2009; 15:362-6.
  17. Kanner AM. Depression in epilepsy: A review of multiple facets of their close relation. NeurolClin 2009; 27:865-80.
  18. Adewuya AO, Oseni SB. Impact of psychiatric morbidity on parent rated quality of life in Nigerian adolescents with epilepsy. Epilepsy Behav 2005; 7:497-501.
  19. Kanner AM, Palac S. Depression in epilepsy: A common but often unrecognized co-morbid malady. Epilepsy Behav 2000; 1:37-51.
  20. Okubadejo NU, Danesi MA, Aina OF, Ojini FI, Adeyemi JD, Olorunshola DA. Prospective case – control study of interictal depression and suicidal ideation in Nigerians with epilepsy. Niger Postgrad Med J 2007; 14:204-8.
  21. Boylan LS, Flint LA, Labovitz DL, Jackson SC, Starner K, Devinsky O. Depression but not epilepsy predicts quality of life in treatment resistant epilepsy. Neurology 2004; 62:258-61.
  22. Forsgren L, Nystrom L. An incident case referent study of epileptic seizures in adults. Epilepsy Res 1990; 6:66-81.
  23. Hesdorffer DC, Hauser WA, Annegers JF, Cascino G. Major depression is a risk factor for seizures in older adults. Ann Neurol 2000; 47:246-9.
  24. Nubukpo P, Houinato D, Preux PM, Avode G, Clement JP. Anxiety and depression among the epileptics in general population in Benin (Western Africa).Encephale 2004; 30:214-9.
  25. Olley BO, Osinowo HO, Brieger WR. Psycho-educational therapy among Nigerian adult patients with epilepsy. Patient Educ Couns 2001; 42:25-33.
  26. Lee SA, Lee SM, No YJ. Factors contributing to depression in patients with epilepsy. Epilepsia 2010; 51:1305-8.
  27. Cramers JA, Blum D, Reed M, Fanning K. The influence of co morbid depression on quality of life for people with epilepsy.Epilepsy behav 2003; 4: 515 - 521.
  28. Perrine K, Hermann BP, Meador KJ, Vickrey BG, et al. The relationship of neuropsychological functioning to quality of life of epilepsy.Arch Neurol 1995; 52: 997 - 1003.
  29. Johnson EK, Jones JE, Seidenberg M, Hennann BP. The relative impact of anxiety, depression and clinical seizures features on health related quality of life in epilepsy. Episepsia 2004; 45: 544 - 550.
  30. Cramer JA, Blum D, Fanning K, Reed M. The impact of co morbid depression on health resource utilization in a community sample of people with epilepsy. Epilepsy Behaviour 2004; 5: 337 – 342.
  31. Jacoby A, Baker GA, Steen N, et al., Epilepsia, 1996;37:148–61.
  32. V Seshadri, J Thomas, and JMK Murthy, CR Raju study on Prevalence of depression and its effect on quality of life in patients with epilepsy (Hyderabad, India). Neurology Asia 2004; 9 (Supplement 1): 139.
  33. Study of Astejada et al. in Philippine, 2004.
  34. Lopez-Gomez et al. study in Mexico 2005.
  35. Grabowska-Grzybetal.studyin Poland 2005.
  36. Study of Hayat Khan & Tahir 2005, major depression risk factors in epilepsy patients.
  37. Study of Nidhinandana et al., study to determine prevalence of depression among epileptic patients in Phramongkutklao Hospital.2007.
  38. Kanitpong et al. (2007), study of prevalence of depression and anxiety in Thai epileptic patients at Songklanagarind Hospital by using cross sectional design.
  39. Delhi psychiatry journal vol. 12 no.L.2009.
  40. Study of Zahiroddin et al.(2008) in Iran, study of prevalence of depression in epilepsy patients.
  41. Study of Thomson & Brennenstuhl (2009) in Canada.
  42. Neurology teaching hospital, P.M.B.01129 ENUGU, Nigeria 2009.
  43. Aziz-Ur-RehmanYousafzai, Abdul Wahab Yousafzai, Rizwan Tajstudy on Frequency Of Depression In Epilepsy: A Hospital Based Study 2009.
  44. Oliveira et al. (2010) in Brazil, study of frequency and intensity of psychiatric disorders in a group of temporal lobe epilepsy patients from a tertiary care centre.
  45. Kutlu et al. (2010) in Turkey, study on health-related quality of life (HRQOL), anxiety and depression states of patients with epilepsy.
  46. Asadi-Pooya & Sperling 2011 in USA,cross sectional study to evaluate the prevalence of anxiety and depression in epilepsy.
  47. IO Onwuekwe et. al (2012)study,( 2012 jan-june,291):10-13 , DOL: 10.4103/2141-9248.96929).
  48. Study of Khalid Z amel, Toufik Alsaadi on depressive disorders in epileptic patients published at vol.5, no.6A1, 14-20(2013), DOI: 10.4234 health.2013.56A1003.
  49. Prevalence and factors associated with depression among patients with epilepsy by Nikuku Kiko, 2013 thesis dissertations/578/1/2.
  50. Vijay Kumar et al., (2015) study on Prevalence of Depression and Adverse drug reactions among South Indian Epileptic patients at Kovai Medical Centre and Hospital, Tamil Nadu.
  51. Berhanu et. al, study of Depression on epilepsy patients in North-East Etiopia, DOI: 10.1186/s13104-015-1515-z).

Corresponding Author

Dr Atul Debbarma

Assistant Professor Agartala Govt. Medical College, Agartala, India