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Meta-Analysis
. 2013 Feb 5;80(6):590-9.
doi: 10.1212/WNL.0b013e31827b1ae0. Epub 2012 Nov 21.

Depression in epilepsy: a systematic review and meta-analysis

Kirsten M Fiest  1 , Jonathan Dykeman, Scott B Patten, Samuel Wiebe, Gilaad G Kaplan, Colleen J Maxwell, Andrew G M Bulloch, Nathalie Jette
Affiliations
Meta-Analysis

Depression in epilepsy: a systematic review and meta-analysis

Kirsten M Fiest et al. Neurology. .

Abstract

Objective: To estimate the prevalence of depression in persons with epilepsy (PWE) and the strength of association between these 2 conditions.

Methods: The MEDLINE (1948-2012), EMBASE (1980-2012), and PsycINFO (1806-2012) databases, reference lists of retrieved articles, and conference abstracts were searched. Content experts were also consulted. Two independent reviewers screened abstracts and extracted data. For inclusion, studies were population-based, original research, and reported on epilepsy and depression. Estimates of depression prevalence among PWE and of the association between epilepsy and depression (estimated with reported odds ratios [ORs]) are provided.

Results: Of 7,106 abstracts screened, 23 articles reported on 14 unique data sources. Nine studies reported on 29,891 PWE who had an overall prevalence of active (current or past-year) depression of 23.1% (95% confidence interval [CI] 20.6%-28.31%). Five of the 14 studies reported on 1,217,024 participants with an overall OR of active depression of 2.77 (95% CI 2.09-3.67) in PWE. For lifetime depression, 4 studies reported on 5,454 PWE, with an overall prevalence of 13.0% (95% CI 5.1-33.1), and 3 studies reported on 4,195 participants with an overall OR of 2.20 (95% CI 1.07-4.51) for PWE.

Conclusions: Epilepsy was significantly associated with depression and depression was observed to be highly prevalent in PWE. These findings highlight the importance of proper identification and management of depression in PWE.

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Figures

Figure 1
Figure 1. Flow chart of studies
OR = odds ratio; prev = prevalence.
Figure 2
Figure 2. Overall prevalence of active depression among persons with epilepsy
CCHS = Canadian Community Health Survey; CI = confidence interval; GP = general practitioners; GPRD = General Practice Research Database; NFO = National Family Opinion.
Figure 3
Figure 3. Overall odds ratio of active depression
CCHS = Canadian Community Health Survey; CHIS = California Health Interview Survey; CI = confidence interval; GP = general practitioners; GPRD = General Practice Research Database; NFO = National Family Opinion; OR = odds ratio.
Figure 4
Figure 4. Overall prevalence of active depression among persons with epilepsy by depression diagnostic tool
CCHS = Canadian Community Health Survey; CES-D = Center for Epidemiologic Studies–Depression Scale; CI = confidence interval; CIDI-SFMD = Composite International Diagnostic Interview Short Form for Major Depression; GPRD = General Practice Research Database; HAD = Hospital Anxiety and Depression Scale; NFO = National Family Opinion.
Figure 5
Figure 5. Overall odds ratio of active depression by depression diagnostic tool
CES-D = Center for Epidemiologic Studies–Depression Scale; CHIS = California Health Interview Survey; CI = confidence interval; CIDI-SFMD = Composite International Diagnostic Interview Short Form for Major Depression; GPRD = General Practice Research Database; K-6 = Kessler-6; NFO = National Family Opinion; OR = odds ratio.
See this image and copyright information in PMC

Comment in

  • The border-land of epilepsy--revisited.
    Barkley GL. Barkley GL. Neurology. 2013 Feb 5;80(6):518-9. doi: 10.1212/WNL.0b013e31827b1b9d. Epub 2012 Nov 21. Neurology. 2013. PMID: 23175729 No abstract available.

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