Magnitude and associated factors of anxiety and depression among children with epilepsy age 8-18 years on follow up at jumc, seizure follow up clinic, south west Ethiopia

Abstract

Background: Epilepsy is a common neurological condition, with close to 80% of people living with epilepsy residing in developing countries. Approximately half of epilepsy in the population occurs during childhood. Epidemiologic studies internationally have shown a strong association between pediatric epilepsy and mental disorders. However, there is limited research on this topic regionally and locally. Objective: The aim of the study was to assess magnitude and associated factors of anxiety and depression among children with epilepsy age 8-18 years on follow up at JUMC, seizure follow up clinic, south west Ethiopia. Methods: Hospital based prospective cross-sectional study was conducted to assess magnitude and associated factors of anxiety and depression among children with epilepsy age 8-18 years on follow up at JUMC, seizure follow up clinic. All children with age 8-18 years who are on follow up at JUMC, and fulfilled inclusion criteria were tried to include in the study during study period. Data was collected by using semi-structured pre-tested questionnaire and Additionally, Revised Child Anxiety and Depression Scale (RCADS) was used as screening tool. A consecutive sampling technique will be used to include all (163) children. The data on the questionnaire was entered into Epi data version 6 and double entry verification was made, and then exported to SPSS version 26 for analysis. Univariate and multivariate logistic regression analysis was done to identify covariates associated with the outcome variable. Statistical significance was considered at a p-value of less than 0.05. Results: Children aged 8-18 years were enrolled based on inclusion criteria. A total of 118 children were included in this study. The study revealed that the majority of participants were male 69(58.5%) and 89(75.4%) of them were below age of 14 years. The mean age of the study participants was 12.20 + 2.863 years. From which 36(30.5%) of them had anxiety and 20(16.9%) of them had depression while and both anxiety and depression identified in 9(8%) % of children. The odds of being first diagnosed at 6 months up to 1 year was 95.8% less likely to develop anxiety compared with those first diagnosed greater than one year (AOR; 0.042, CI; 0.004, 0.400, P=0.006). The odds of being taking monotherapy was 90.2% times less likely develop anxiety as compared with those who take polytherapy (AOR; 0.098, CI; 0.028, 0.345, P=0.001). Factors associated with depression is being the odds male was 5 times more likely to have depression as compared with being female AOR= 5.392, CI: 1.121, 25.947; P= 0.036), similarly, the odds of being age less than 14 was 80.2% less likely to develop anxiety and depression at a time as compared with age greater than 14 years old (AOR= 0.198, CI: 0.041, 0.960, P= 0.044). Finally, the odds of being have a good relationship between mother and father or guardians was 88.6% less likely to develop anxiety and depression as compared to poor relationship between mother and father or guardians (AOR = 0.114, CI: 0.016, 0.819, P = 0.03). Conclusion: This study has found out that significant number of CWE under our care also have a co morbid behavioral disorders. Physicians attending to these adolescents should therefore carefully evaluate them with respect to the possible risk factors. This can easily be minimized by regular assessment and addressing the problem early.