Abstracts

Rationale: Epilepsy is a chronic disorder that has complex relations with social, vocational and psychological functioning. Previous studies showed that frequency of mood disorders in patients with epilepsy is increased. Self-reported quality of life assessment showed its stronger association with depression, than with seizure factors. Studies from developed countries suggest that prevalence of depression ranges between 20-55% in medically refractory epilepsy and it is lower, but still increased, in the patients with fully controlled seizures. However, there are only few studies performed in developing countries, with different social and vocational background. In this study we evaluated prevalence of depressive symptoms in epilepsy patients in Croatia. Methods: We examined 80 consecutive and consenting epilepsy patients in a tertiary epilepsy clinic at the Zagreb Epilepsy Center. Clinical data for patients included age, gender, seizure factors (seizure frequency, type of epilepsy, epilepsy duration and time to initial diagnosis), education, employment and marital status. Seizure frequency was self-reported by the patients and then averaged for each month for the previous six months. All subjects were also assessed for mood dysfunction in a psychiatric interview and with the Beck Depression Inventory (BDI). Results: Mean age of the patients was 30±12 years. Majority were females (63.8%), employed (66.3%), single (66.3%) and 32.5% were with a university degree. Most of the patients had complex partial seizures (n= 66, 86.8%), and 8 (10.5%) were diagnosed with primary generalized epilepsy. For six patients the type of epilepsy was not defined. The mean seizure frequency was 2.4±5.8 and epilepsy duration 10.55±8.9 years. Assessment with the BDI showed that 32.9% of patients had recent depressive symptoms: 5.3% had mild, 13.1% moderate and 14.5% had severe depressive symptoms. Six (7.5%) patients had recent suicidal ideation. Multivariate regression analysis showed that suicidal ideation was predicted by the presence of depression (p< 0.003) and not by patients’ age or seizure factors.Conclusions: This is the first study assessing mood dysfunction in epilepsy patients in Croatia. We confirmed an increased prevalence of depression in epilepsy patients and showed that every third patient had recent depressive symptoms. Our results suggest similar prevalence of depression in epilepsy in developing countries, indicating less significant role of social and vocational factors in the etiology of the disease. This work was supported by the Epilepsy Foundation grant to Hrvoje Hecimovic.