Depressive symptoms in patients with epilepsy: Analysis of self-rating and physician's assessment

Background: Depression has significant negative impact on the quality of life in patients with epilepsy (PWE). Aim: This study assessed the prevalence of depression in PWE and the impact of seizure variables on the depression scores. Settings and Design: A case-control study of randomly selected PWE attending a tertiary hospital in a metropolitan, Nigeria. Materials and Methods: A total of 152 randomly selected subjects the Beck Depression Inventory (BDI) for quantitative assessment of depression, while the Hamilton Rating Scale for Depression (HRSD) was used by the investigators. Statistical Analysis: The Student t test assessed statistical significance of differences in the BDI and HRSD scores, whereas the scores were correlated with Pearson's correlation coefficient. Logistic regression analysis and Chi-square test for trend assessed the impact of seizure variables on the scores. The level of significance was taken as P < 0.05. Results: The prevalence of depressive symptoms was 42% and 45% using the HRSD and BDI, respectively, with significant differences in the scores of the patients and controls on the both scales (P < 0.001). The PWE scores on both scales yielded a correlation coefficient of 0.8 indicating their utility in detecting depressive symptoms. Seizure control was the most potent predictor of depression (HRSD: P = 0.004; BDI: P = 0.001). Conclusions: Depressive symptoms are common in epilepsy. Early detection and prompt management are recommended. Good seizure control with an appropriate antiepileptic drug, among other interventional measures, may contribute to the prevention of depression in epilepsy.