DEPRESSION AND ANXIETY SYMPTOMS AMONG ADOLESCENTS WITH EPILEPSY IN ACCRA, GHANA

Abstract

Background: Epilepsy is one of the most common chronic conditions and the most prevalent neurological disorder of childhood. It is known to be associated with high rates of mental health problems, with anxiety and depression being among the most common. There is a dearth of literature on mental health in Ghana and even more so in child and adolescent mental health. The aim of this study was to determine the prevalence of anxiety and depressive symptoms among adolescents with epilepsy in Accra, Ghana. Methodology: Cross-sectional study design was used and a total enumeration of adolescents who met the study criteria was done. Participants were recruited consecutively. Adolescents with epilepsy (10 to 19 years) were screened for symptoms of anxiety and depression using Beck’s anxiety Inventory (BAI) and Beck’s Depression Inventory (BDI). Participants were surveyed in 2 psychiatric hospitals and 2 two neurology clinics. Data on previous diagnosis and treatment of depression or anxiety was obtained from participants’ clinical folders. Data obtained was analyzed using the Statistical Package for Social Sciences software version 16. The proportion of adolescents with epilepsy who screened positive for anxiety and depression based on cut-off scores on the BAI (scores > 10) and BDI (scores > 17). respectively; was determined. The association between anxiety and depression and selected demographic characteristics and seizure variables was described. Results: A total of 61 participants were surveyed, 31 males and 30 females between the ages of 10 to 19 years. More than half of the participants (57.4%) had BAI scores that met the cutoff criteria for anxiety, 30.5% had BDI scores that met the cutoff criteria for depression and 25.4% met the criteria for both. The study found no significant association between age and depression or anxiety. No significant association was found between sex and anxiety or depression. Depression and anxiety were however found to be more prevalent among females than males; 37% of females screened positive for depression compared to 23% of males and 67% of females screened positive for anxiety compared to 48% of males. The prevalence of anxiety was found to be higher among younger adolescents (64%) compared to older adolescents (56%) whereas the prevalence of depression was higher among older adolescents (33%) compared to younger adolescents. There was no significant association between seizure variables (seizure type, onset of seizures, duration of epilepsy, seizure frequency and type of therapy) and depression and anxiety. It was however observed that, participants who had complex partial seizure type had higher a prevalence of both conditions compared to the prevalence among other seizure types. Participants with ongoing seizures were also found to have a higher prevalence of depression and participants on polytherapy were observed to have a higher prevalence of anxiety. It was also observed that only one patient had a previous diagnosis of depression/anxiety and none of the participants was receiving any form of mental health care. Conclusion: Depression and anxiety symptoms are common among adolescents with epilepsy in Accra, Ghana however these are not often recognized