Prevalence of Depression and Associated Factors Among Patients With Epilepsy at Kenyatta National Hospital, Kenya

Abstract

Introduction: Depressive disorders are common comorbidities occurring in approximately 34.5% of epileptic patients. Patients with depressive disorders are at high risk of self-harm and suicide. People with epilepsy are more likely to develop depression and other mood disorders even prior to having their first episode of seizure. Despite the high prevalence of epilepsy in sub-Saharan Africa and the established relationship between depression and epilepsy, the extent of comorbid epilepsy and depression in the region is still poorly understood. Study Objective: To determine the prevalence and factors associated with depressive disorder among epileptic patients at the neurology outpatient clinic in Kenyatta National Hospital. Methodology. This was descriptive cross-sectional study that was conducted at Kenyatta National Referral Hospital (KNH)- outpatient neurology clinic. Data was collected from 139 epileptic patients recruited via purposive sampling at the neurology outpatient clinic at the Kenyatta National Hospital. Data collection was done using a structured questionnaire. Both descriptive and inferential analysis was done using SPSS version 26. Results: The results identified that, 39.6% were aged <30 years, 51.1% of the patients were male. In investigating marital status, 65.5% were single, 42.4 %(59) had secondary level education, 53.2%(74) of the respondents were unemployed. Further, 68% of epileptic patients had depression, (95%CI: 60% - 75.9%), 45.3% had mild depression, 36.8% had moderate depression, 15.8% had moderately severe depression while 2.1% had severe depression. Among patients with depression, 22.1% had a history of psychiatric illness in their family, the average age at first seizure was 22.8(SD±17) years with an average duration of seizures 12(SD±10) years. Generalized seizure 77.8 %(74) was a common type of seizure among patients, 92.6%(88) were using epileptic drugs with an average of 2(SD±0.8) different drugs. Multivariable analysis established that no formal education (AOR =16.83, 95%CI: 2.57 – 110.08, <0.001), discriminated because of epilepsy (AOR =6.61, 95%CI: 1.29 – 33.74, p =0.023), longer duration of seizure (AOR =1.07, 95%CI:1.02 – 1.13, p =0.006) and history of antiepileptic drugs default were independently associated with depression among epileptic patients. Conclusion and recommendations: The prevalence of depression is high among adult epileptic patients which provides the need for regular assessment and integration of family social support and high-level awareness the of increased risk of depression within this group