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

Abstract

Purpose The purpose of this study was to determine the frequency of depressive symptoms in patients with epilepsy (PWE) in a tertiary epilepsy center and, then analyze possible predictors of depression from several domains, including clinical characteristics of epilepsy and sociodemographic factors Methods PWE who visited our epilepsy clinic during 6th months period in 2020 and 2021 were enrolled in our study. In order to collect data, structured scales were created for the clinical characteristics of the disease and sociodemographic data. All participants completed Back Depression Inventory II (BDI-II). Univariate analysis and binary logistic regression were conducted to identify the factors associated with depressive symptoms in PWE. Results A total of 131 PWE were recruited in this study. It was determined that depressive symptoms were represented in 51.1% PWE. Of these, 49.25% manifest severe depressive symptoms. It was determined that about 18% of PWE use antidepressant medications which is significantly less in comparison to those PWE who are currently depressed. Univariate regression analysis showed that female gender (p = 0.013); severe seizure frequency in the past year (p = 0.001); antiseizure medication polytherapy (p = 0.018); presence of side effects of antiseizure medications (p = 0.001); history of febrile seizures (p = 0.015); focal impaired awareness seizures (p = 0,051), as well as a combination of focal aware seizures to focal impaired awareness seizures to bilateral tonic-clonic seizures (p = 0,006) may associate with depressive symptoms in PWE. 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 gender (OR = 2.16; 95% CI: 0.984–4.73), as well as the combination of focal aware seizures to focal impaired awareness seizures to bilateral tonic-clonic seizures (OR = 7.32; 95% CI: 0.830–64.59) represent unique, independent predictors of depressive symptoms in patients with epilepsy. Conclusion Depressive symptoms in PWE are frequent, severe, undiagnosed, and mostly untreated. Side effects of antiseizure medications, history of febrile seizures, female gender, as well as the combination of focal aware seizures to focal impaired awareness seizures to bilateral tonic-clonic seizures represent unique, independent predictors of depressive symptoms in PWE.