Association of depression and epilepsy in Rwanda: A prospective longitudinal study
•In Rwanda, the incidence of moderate to severe depression in persons living with epilepsy is 32.7/1000 patient-years.•In Rwanda, the prevalence of any depression in persons living with epilepsy is 14.2%.•In Rwanda, the prevalence of moderate to severe depression in persons living with epilepsy is 4...
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Published in | Epilepsy & behavior Vol. 138; p. 108993 |
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Main Authors | , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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Elsevier Inc
01.01.2023
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Abstract | •In Rwanda, the incidence of moderate to severe depression in persons living with epilepsy is 32.7/1000 patient-years.•In Rwanda, the prevalence of any depression in persons living with epilepsy is 14.2%.•In Rwanda, the prevalence of moderate to severe depression in persons living with epilepsy is 4.7%.•The Patient Health Questionnaire-9 & Hamilton Depression Rating Scale depression screening tools are available in Kinyarwanda.•Regular six-monthly administration of these tools to detect any depression in persons living with epilepsy is recommended.
Depression is the most common psychiatric comorbidity for persons living with epilepsy. In Rwanda, the prevalence of epilepsy and depression are high, with 4,9% and 13.0% respectively. This prospective interventional study aimed to determine the prevalence and incidence of depression and the outcome of persons living with epilepsy (PwE) with depression attending the outpatient neurology department of a tertiary center.
Persons living with epilepsy enrolled between February and June 2018 in a screening cohort with a 12-month follow-up. At every 3-month study visit, PwE were screened for depression using the Patient Health Questionnaire (PHQ-9) questionnaire. Any positively screened subject was administered the Hamilton Depression Rating Scale (HDRS) to confirm the diagnosis and severity of depression. Subjects with moderate to severe depression (MSD), were started on treatment and were followed for another year. We describe the prevalence and incidence of depression, baseline characteristics, epilepsy and depression outcomes, and changes in PGI-C.
Of 572 PwE enrolled, 46 were diagnosed with MSD in a twelve-month period, resulting in an incidence of MSD of 32.7/1000 patient-years. The prevalence of any depression and MSD was 14.2% and 4.7%, respectively. Longer epilepsy duration and seizure status at baseline were associated with MSD. Significant improvements in PGI-C and seizure frequency were observed after treatment optimization.
The use of PHQ-9 and HDRS proved successful in identifying depression in PwE. Combined treatment of epilepsy and depression resulted in improved outcomes, warranting the implementation of depression screening every six months in daily neurology practice. |
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AbstractList | INTRODUCTIONDepression is the most common psychiatric comorbidity for persons living with epilepsy. In Rwanda, the prevalence of epilepsy and depression are high, with 4,9% and 13.0% respectively. This prospective interventional study aimed to determine the prevalence and incidence of depression and the outcome of persons living with epilepsy (PwE) with depression attending the outpatient neurology department of a tertiary center. METHODSPersons living with epilepsy enrolled between February and June 2018 in a screening cohort with a 12-month follow-up. At every 3-month study visit, PwE were screened for depression using the Patient Health Questionnaire (PHQ-9) questionnaire. Any positively screened subject was administered the Hamilton Depression Rating Scale (HDRS) to confirm the diagnosis and severity of depression. Subjects with moderate to severe depression (MSD), were started on treatment and were followed for another year. We describe the prevalence and incidence of depression, baseline characteristics, epilepsy and depression outcomes, and changes in PGI-C. RESULTSOf 572 PwE enrolled, 46 were diagnosed with MSD in a twelve-month period, resulting in an incidence of MSD of 32.7/1000 patient-years. The prevalence of any depression and MSD was 14.2% and 4.7%, respectively. Longer epilepsy duration and seizure status at baseline were associated with MSD. Significant improvements in PGI-C and seizure frequency were observed after treatment optimization. CONCLUSIONThe use of PHQ-9 and HDRS proved successful in identifying depression in PwE. Combined treatment of epilepsy and depression resulted in improved outcomes, warranting the implementation of depression screening every six months in daily neurology practice. Depression is the most common psychiatric comorbidity for persons living with epilepsy. In Rwanda, the prevalence of epilepsy and depression are high, with 4,9% and 13.0% respectively. This prospective interventional study aimed to determine the prevalence and incidence of depression and the outcome of persons living with epilepsy (PwE) with depression attending the outpatient neurology department of a tertiary center. Persons living with epilepsy enrolled between February and June 2018 in a screening cohort with a 12-month follow-up. At every 3-month study visit, PwE were screened for depression using the Patient Health Questionnaire (PHQ-9) questionnaire. Any positively screened subject was administered the Hamilton Depression Rating Scale (HDRS) to confirm the diagnosis and severity of depression. Subjects with moderate to severe depression (MSD), were started on treatment and were followed for another year. We describe the prevalence and incidence of depression, baseline characteristics, epilepsy and depression outcomes, and changes in PGI-C. Of 572 PwE enrolled, 46 were diagnosed with MSD in a twelve-month period, resulting in an incidence of MSD of 32.7/1000 patient-years. The prevalence of any depression and MSD was 14.2% and 4.7%, respectively. Longer epilepsy duration and seizure status at baseline were associated with MSD. Significant improvements in PGI-C and seizure frequency were observed after treatment optimization. The use of PHQ-9 and HDRS proved successful in identifying depression in PwE. Combined treatment of epilepsy and depression resulted in improved outcomes, warranting the implementation of depression screening every six months in daily neurology practice. •In Rwanda, the incidence of moderate to severe depression in persons living with epilepsy is 32.7/1000 patient-years.•In Rwanda, the prevalence of any depression in persons living with epilepsy is 14.2%.•In Rwanda, the prevalence of moderate to severe depression in persons living with epilepsy is 4.7%.•The Patient Health Questionnaire-9 & Hamilton Depression Rating Scale depression screening tools are available in Kinyarwanda.•Regular six-monthly administration of these tools to detect any depression in persons living with epilepsy is recommended. Depression is the most common psychiatric comorbidity for persons living with epilepsy. In Rwanda, the prevalence of epilepsy and depression are high, with 4,9% and 13.0% respectively. This prospective interventional study aimed to determine the prevalence and incidence of depression and the outcome of persons living with epilepsy (PwE) with depression attending the outpatient neurology department of a tertiary center. Persons living with epilepsy enrolled between February and June 2018 in a screening cohort with a 12-month follow-up. At every 3-month study visit, PwE were screened for depression using the Patient Health Questionnaire (PHQ-9) questionnaire. Any positively screened subject was administered the Hamilton Depression Rating Scale (HDRS) to confirm the diagnosis and severity of depression. Subjects with moderate to severe depression (MSD), were started on treatment and were followed for another year. We describe the prevalence and incidence of depression, baseline characteristics, epilepsy and depression outcomes, and changes in PGI-C. Of 572 PwE enrolled, 46 were diagnosed with MSD in a twelve-month period, resulting in an incidence of MSD of 32.7/1000 patient-years. The prevalence of any depression and MSD was 14.2% and 4.7%, respectively. Longer epilepsy duration and seizure status at baseline were associated with MSD. Significant improvements in PGI-C and seizure frequency were observed after treatment optimization. The use of PHQ-9 and HDRS proved successful in identifying depression in PwE. Combined treatment of epilepsy and depression resulted in improved outcomes, warranting the implementation of depression screening every six months in daily neurology practice. |
ArticleNumber | 108993 |
Author | Ndayisenga, Arlene Garrez, Ieme Leers, Tim Umwiringirwa, Josiane Ndacyayisenga, Jean-Pierre Umuhoza, Georgette Dedeken, Peter Sebera, Fidele Teuwen, Dirk E. Boon, Paul A.M.J. Mutungirehe, Sylvestre Niyonzima, Odette |
Author_xml | – sequence: 1 givenname: Fidele surname: Sebera fullname: Sebera, Fidele organization: Neurology Department, CARAES Neuropsychiatric Hospital, Kigali, Rwanda – sequence: 2 givenname: Peter surname: Dedeken fullname: Dedeken, Peter organization: Department of Neurology, University Hospital, Ghent University, Ghent, Belgium – sequence: 3 givenname: Ieme surname: Garrez fullname: Garrez, Ieme organization: Department of Neurology, University Hospital, Ghent University, Ghent, Belgium – sequence: 4 givenname: Josiane surname: Umwiringirwa fullname: Umwiringirwa, Josiane organization: Neurology Department, CARAES Neuropsychiatric Hospital, Kigali, Rwanda – sequence: 5 givenname: Tim surname: Leers fullname: Leers, Tim organization: WIWO Hospital, Nyarugenge District, Kigali, Rwanda – sequence: 6 givenname: Jean-Pierre surname: Ndacyayisenga fullname: Ndacyayisenga, Jean-Pierre organization: Neurology Department, CARAES Neuropsychiatric Hospital, Kigali, Rwanda – sequence: 7 givenname: Sylvestre surname: Mutungirehe fullname: Mutungirehe, Sylvestre organization: Neurology Department, CARAES Neuropsychiatric Hospital, Kigali, Rwanda – sequence: 8 givenname: Arlene surname: Ndayisenga fullname: Ndayisenga, Arlene organization: Neurology Department, CARAES Neuropsychiatric Hospital, Kigali, Rwanda – sequence: 9 givenname: Odette surname: Niyonzima fullname: Niyonzima, Odette organization: Neurology Department, CARAES Neuropsychiatric Hospital, Kigali, Rwanda – sequence: 10 givenname: Georgette surname: Umuhoza fullname: Umuhoza, Georgette organization: Neurology Department, CARAES Neuropsychiatric Hospital, Kigali, Rwanda – sequence: 11 givenname: Dirk E. surname: Teuwen fullname: Teuwen, Dirk E. email: dirk.teuwen@uzgent.be organization: Department of Neurology, University Hospital, Ghent University, Ghent, Belgium – sequence: 12 givenname: Paul A.M.J. surname: Boon fullname: Boon, Paul A.M.J. organization: Department of Neurology, University Hospital, Ghent University, Ghent, Belgium |
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CitedBy_id | crossref_primary_10_1016_j_jad_2023_03_054 crossref_primary_10_5498_wjp_v14_i6_985 crossref_primary_10_2147_PRBM_S406386 crossref_primary_10_3389_fneur_2024_1352648 |
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Keywords | Prevalence PWED Epilepsy PHQ-9 Incidence QOLIE scr-PPS MSD-PPS SD PPS CBT ASM HDRS MSD scr-CS PGI-C AD CI Rwanda Depression MSD-CS n CS TSP SSRI TCA y PwE |
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Snippet | •In Rwanda, the incidence of moderate to severe depression in persons living with epilepsy is 32.7/1000 patient-years.•In Rwanda, the prevalence of any... Depression is the most common psychiatric comorbidity for persons living with epilepsy. In Rwanda, the prevalence of epilepsy and depression are high, with... INTRODUCTIONDepression is the most common psychiatric comorbidity for persons living with epilepsy. In Rwanda, the prevalence of epilepsy and depression are... |
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SubjectTerms | Depression Depression - epidemiology Depression - psychology Epilepsy Epilepsy - complications Epilepsy - epidemiology Epilepsy - psychology Humans Incidence Longitudinal Studies Prevalence Prospective Studies Rwanda Rwanda - epidemiology Seizures - complications |
Title | Association of depression and epilepsy in Rwanda: A prospective longitudinal study |
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