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CC BY-NC-ND 4.0 · International Journal of Epilepsy 2017; 04(01): 026-030
DOI: 10.1016/j.ijep.2016.12.002
Original article
Thieme Medical and Scientific Publishers Private Ltd.

Psychiatric comorbidity in African patients with epilepsy – Experience from Sierra Leone

Tenema M’bayo  
a   College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
,
Michal Tomek  
b   Department of Medicine, Basildon & Thurrock University Hospitals NHS Foundation Trust, Basildon, United Kingdom
,
Clifford Kamara
a   College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
,
Durodami Radcliffe Lisk
a   College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
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Publikationsverlauf

Received: 29. Juni 2016

Accepted: 05. Dezember 2016

Publikationsdatum:
06. Mai 2018 (online)

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Abstract

Objective Epilepsy is associated with a significant burden of psychiatric comorbidity, including depression and anxiety disorders. However, paucity of data exists regarding the impact of epilepsy on mental health of patients in the setting of sub-Saharan Africa, where these comorbidities are under-recognized and under-treated. We carried out a cross-sectional descriptive study to investigate the prevalence and determinants of depression and anxiety among people with epilepsy in Sierra Leone.

Method A screening tool previously validated in the primary healthcare setting in Zambia was administered to adult patients in our epilepsy clinics in Freetown and Kenema, Sierra Leone. In addition, various socio-demographic and clinical characteristics were recorded for each patient.

Results A total of 142 patients were included. The mean screening score was 16.3 out of 40, with 39 (27.5%) patients scoring above the diagnostic cut-off point for anxiety and/or depression. Variables showing a significant association with the presence of psychiatric comorbidity included female gender (p = 0.015), seizure frequency of >2 per month (p = 0.001), and self-reporting of sedation and/or dizziness as side effects of anti-epileptic medications (p = 0.006).

Conclusion Symptoms of anxiety and depression are common in epilepsy patients in Sierra Leone. Given the significant negative impacts of such comorbidity on those affected, primary healthcare workers in sub-Saharan countries should be trained to inquire about anxiety and depression symptoms in epilepsy patients, and implementation of screening programs should be considered.

Keywords

Epilepsy - Seizure - Depression and/or anxiety - Sub-Saharan Africa

1Shared First Authorship.