The point prevalence of major depressive disorder (MDD) is estimated to be 21.9% among patients with epilepsy who are managed in epilepsy clinics and is higher among women than among men, according to study results published in Epilepsy & Behavior.
Depression is a common psychiatric comorbidity among individuals with epilepsy, but its prevalence appears to be underestimated. The presence of comorbid depression in epilepsy can have negative impacts on treatment outcomes and quality of life and is also associated with fatigue, irritability, and suicidality. The current meta-analysis was performed to estimate the frequency of MDD in people with epilepsy who are treated at epilepsy clinics.
Among the 35 studies included in the meta-analysis from 1996 to 2017, the total number of patients with epilepsy was 5434. The most commonly used method for the diagnosis of MDD among the studies was the Mini-International Neuropsychiatric Inventory (27 of 35 studies), followed by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition axis I disorders (6 of 35 studies) and the Composite International Diagnostic Interview (2 of 35 studies).
The point prevalence of MDD was 25.6% (95% CI, 21.6-30.2) in Africa, 21.4% (95% CI, 19.5-23.5) in Asia, 23.1% (95% CI, 18.5-28.4) in Australia, 22.7% (95% CI, 20.7-24.0) in Europe, 15.9% (95% CI, 13.5-18.6) in North America, and 24.9% (95% CI, 21.3-28.8) in South America.
Limitations of the current meta-analysis include that all primary studies were conducted in epilepsy clinics in tertiary care hospitals, and there were no population-based studies. Thus, it was not possible to determine the true prevalence of MDD among individuals with epilepsy.
The investigators concluded that the point prevalence of MDD among patients with epilepsy — 21.9% — is higher than that in the general population. Moreover, the prevalence of MDD among in patients with epilepsy is higher among women (26.4%) than among men (16.7%). Further consideration of depressive disorders in patients with epilepsy may help improve patient outcomes and quality of life.
Kim M, Kim YS, Kim DH, Yang TW, Kwon OY. Major depressive disorder in epilepsy clinics: a meta-analysis. Epilepsy Behav. 2018;84:56-69.