Date of Award

2013

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

J. O. Jowi

Second Supervisor/Advisor

N. Kitazi

Department

Internal Medicine (East Africa)

Abstract

Aim: To determine the prevalence and factors associated with depression in patients with epilepsy at Aga Khan University Hospital Nairobi.

Design: Cross-sectional Survey

Background: Depression is a recognized common co-morbidity of epilepsy that often goes untreated and has great impact on quality of life of patients and management of patients with epilepsy.

Patients and Setting: Patients with epilepsy on follow up at the Aga Khan University Hospital were evaluated for presence and factors associated with depression.

Methodology: The study recruited eligible patients with epilepsy who were on follow up in the neurology clinic. Beck Depression Inventory was administered to evaluate for presence of depression. Patients identified as having co-morbid depression were evaluated for associated factors.

Results: Three hundred and twenty seven patients were evaluated for presence of depression in this study. The prevalence of depression based on the Beck Depression Inventory was 16.5 %, (95 % CI 12.7-21.0) representing a total of 54 patients diagnosed to have depression among the 327 patients with epilepsy. Twenty five patients (7.6%)[95% CI 5-11.1] as a subset of the total study population, had mild depression, 18 (5.5% [95% CI 3.3-8.6]) patients had moderate depression and 11 (3.4%[95% CI 1.7-5.9]) patients had severe depression.

There was weak association between mild depression and polytherapy (use of two or more antiepileptic drugs), with OR 2.3, 95%CI 0.9-5.8 however, none between polytherapy and moderate or severe depression. No statistically significant association was found between depression and duration of epilepsy or number of seizures per month over last three months.

Conclusion: Based on these results, we concluded that the prevalence of depression in patients with epilepsy at Aga Khan University Hospital, Nairobi was 16.5 %( 95% CI 12.7-21.0) and polytherapy was weakly associated with mild depression.

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