Clinical and sociodemographic predictors of depressive symptoms in epilepsy patients in a single tertiary epilepsy center

Abstract

Purpose: The purpose of this cross-sectional study was to determine the frequency of depressive symptoms in patients with epilepsy (PWE) in a tertiary epilepsy center and to analyse possible predictors of depression in several domains, including clinical characteristics of epilepsy and sociodemographic factors.

Methods: PWE patients who visited our epilepsy clinic during the 6th month in 2020 and 2021 were enrolled in our study. To collect the data, structured scales were created for the clinical characteristics of the disease and for the sociodemographic data. All participants completed the Back Depression Inventory II (BDI-II). Univariate analysis and binary logistic regression were also conducted to identify the factors associated with depressive symptoms in PWE.

Results: A total of 131 PWE were recruited for this study. It was determined that depressive symptoms were present in 51.1% of PWE. Of these, 49.25% manifested severe depressive symptoms. Approximately 18% of PWE use antidepressant medications, which is significantly less than that of PWE who are currently depressed. Univariate regression analysis revealed that female sex (p = 0.013), severe seizure frequency in the past year (p = 0.001), the use of the antiseizure medication polytherapy (p = 0.018), the presence of side effects of antiseizure medications (p = 0.001), a history of febrile seizures (p = 0.015), focal impaired awareness seizures (p = 0,051), and a combination of focal aware seizures with focal impaired awareness seizures combined with bilateral tonic‒clonic seizures (p = 0,006) may be associated with depressive symptoms in PWE patients. Binary logistic regression analysis demonstrated that side effects of antiseizure medications (OR = 3.01; 95% CI = 1.09-8.32), history of febrile seizures (OR = 3.75; 95% CI = 1.07-13.11), female sex (OR = 2.16; 95% CI = 0.984-4.73), and combination of focal aware seizures to focal impaired awareness seizures to bilateral tonic‒clonic seizures (OR = 7.32; 95% CI = 0.830-64.59) were unique, independent predictors of depressive symptoms in patients with epilepsy.

Conclusion: Depressive symptoms in PWE are frequent, severe, undiagnosed, and mostly untreated. The side effects of antiseizure medications, history of febrile seizures, female sex, and combination of focal awareness seizures and focal impaired awareness seizures combined with bilateral tonic‒clonic seizures are unique, independent predictors of depressive symptoms in PWE.

Keywords: Depression; Epilepsy; Risk factors.