Prevalence and risk factors of anxiety and depression in adult patients with epilepsy: a multicenter survey-based study

Wenyan Shi; Hanlin Sun; Wei Peng; Ziyi Chen; Qun Wang; Weihong Lin; Meiping Ding; Hongbin Sun; Xiangqing Wang; Tiancheng Wang; Xuefeng Wang; Yonghong Liu; Yangmei Chen; Guoxing Zhu; Dong Zhou; Jinmei Li

doi:10.1177/17562864231187194

Prevalence and risk factors of anxiety and depression in adult patients with epilepsy: a multicenter survey-based study

Ther Adv Neurol Disord. 2023 Aug 30:16:17562864231187194. doi: 10.1177/17562864231187194. eCollection 2023.

Authors

Wenyan Shi¹, Hanlin Sun¹, Wei Peng¹, Ziyi Chen², Qun Wang³, Weihong Lin⁴, Meiping Ding⁵, Hongbin Sun⁶, Xiangqing Wang⁷, Tiancheng Wang⁸, Xuefeng Wang⁹, Yonghong Liu¹⁰, Yangmei Chen¹¹, Guoxing Zhu¹², Dong Zhou¹³, Jinmei Li¹³

Affiliations

¹ Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
² Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
³ Department of Neurology, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China.
⁴ Department of Neurology, The First Hospital of Jilin University, Changchun, China.
⁵ Department of Neurology, The Second Affiliated Hospital of Zhejiang University, Hangzhou, China.
⁶ Department of Neurology, Sichuan Provincial People's Hospital, Chengdu, China.
⁷ Department of Neurology, Chinese People's Liberation Army General Hospital, Beijing, China.
⁸ Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China.
⁹ Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
¹⁰ Department of Neurology, Air Force Medical University Xijing Hospital, Xi'an, China.
¹¹ Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
¹² Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
¹³ Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, 610041, China.

Abstract

Background: Depression and anxiety are the most common psychiatric comorbidities in patients with epilepsy (PWE). However, they are often unrecognized and consequently untreated.

Objective: The study was conducted to evaluate the prevalence and risk factors of anxiety and depression among Chinese adult PWE.

Design: Cross-sectional study.

Methods: Adult PWE were recruited from 13 tertiary epilepsy centers from February to September 2022. Generalized Anxiety Disorder-7 and Neurological Disorders Depression Inventory for Epilepsy were applied to evaluate anxiety and depression, respectively. Both univariate and multivariate logistic regression analyses models were performed to explore the risk factors of anxiety and depression.

Results: A total of 1326 PWE were enrolled in this study. The prevalence of anxiety and depression was 31.45% and 27.30%, respectively. Being female [odds ratio (OR) = 1.467, 95% CI: 1.134-1.899; p = 0.004], focal and focal to bilateral tonic-clonic seizures (TCSZ) (OR = 1.409, 95% CI: 1.021-1.939; p = 0.036), and seizure occurrence in the last 3 months (OR = 1.445, 95% CI: 1.026-2.044; p = 0.036) were the risk factors for anxiety. Focal and focal to bilateral TCSZ (OR = 1.531, 95% CI: 1.094-2.138; p = 0.013) and seizure occurrence in the last 3 months (OR = 1.644, 95% CI: 1.130-2.411; p = 0.010) were the risk factors for depression. In addition, for every 1-year increment of age, the odds of developing depression were decreased by 3.8% (p = 4.12e^-5). Nevertheless, up to 70% of PWE did not receive any treatment for comorbidity.

Conclusion: There were approximately 30% of PWE screened positive for anxiety or depression. Both focal and focal to bilateral TCSZ and seizure occurrence in the last 3 months were estimated as risk factors for anxiety and depression. However, the current status of treatment was not optimal.

Keywords: anxiety; current status of treatment; depression; epilepsy; risk factors.