Prevalence and Factors Associated with Depression among Patients with Epilepsy at Aga Khan University Teaching Hospital Nairobi

Abstract

Objective: To determine the prevalence and factors associated with depression in patients with epilepsy at Aga Khan University Hospital; Nairobi. Design: A Cross-Sectional Survey. Setting: Neurology clinic, Aga Khan University Hospital; Nairobi Subjects: Eligible patients with epilepsy on follow-up at the neurology clinic were recruited. Intervention: Beck-Depression-Inventory was administered to evaluate presence of depression. Main Outcome Measures: In addition to depression, patients with co-morbid depression were further evaluated for associated factors. Results: Three-hundred-and-twenty-seven patients were evaluated for presence of depression. Fifty-four patients in the study cohort had depression, giving prevalence of depression; based on the Beck-Depression-Inventory as 16.5 %, (95 % CI 12.7-21.0) There was weak association between mild depression and polytherapy (use of two or more antiepileptic drugs), with OR 2.3, 95%CI 0.9-5.8 however, none between polytherapy and moderate or severe depression. No statistically significant association was found between depression and duration of epilepsy or number of seizures per month over last three months. Conclusion: The prevalence of depression in patients with epilepsy at Aga Khan University Hospital, Nairobi was 16.5 %( 95% CI 12.7-21.0) and polytherapy was weakly associated with mild depression. Depression among patients with epilepsy warrants clinical attention especially in patients on polytherapy. The risk of AED polytherapy was two-fold greater (OR 2.3, 95%CI 0.9-5.8) in patients with mild depression compared to patients with epilepsy without depression.