Risk factors for depression in epileptic patients

Background: Depression is the most frequent psychiatric comorbidity in patients with epilepsy, with significant consequences, including increased drug use, poor quality of life, social disability, and mortality. Yet, co-morbid depression remains under-recognized and untreated in a significant number of patients with epilepsy.

Purpose: To analyze the risk factors for depression in epileptic patients.

Methods: Data were from 140 patients seen in a specific hospital in China. Psychosocial well- being was assessed using two clinical scales: (1) HAMD (Hamilton Depression Scale) and (2) QOLIE-31(Quality of Life in Epilepsy-31). Co-morbid depression was diagnosed by using criteria from CCMD-3(Chinese Classification of Mental Disorders-3). We evaluated risk factors for depression using logistic regression models.

Results: Epileptic patients with two or more seizure types (AOR=3.77), complex partial seizure; AOR=8.93), decreased social functioning (AOR=1.06), and worries about seizure occurring and accompanied shameful situations (AOR=1.06) were more likely to develop depression in a model that controlled for gender and other risk factors (primary or secondary epilepsy, intractable epilepsy, account of AEDs (Antiepileptic Drugs), onset of epilepsy (year of age), duration of epilepsy, and having drugs that could impact patients' mood.

Conclusion: Co-morbid depression in epileptic patients could be related to both the disease of epilepsy and psychosocial factors. Given the high morbidity rate in patients with epilepsy, health providers, especially neurological clinicians, must carefully monitor the psychological status of their epileptic patients. Furthermore, preventing risk factors for depression is of the essence to increase patients' quality of life and to avert their physical and economic burden .