Anxiety and depression are underrecognised and undertreated in adults with epilepsy, according to Australian research.
The findings confirm earlier research such as a Canadian study which found only 70% of people with epilepsy and current depression were not receiving either antidepressant medications or non-pharmacological treatments.
The Australian study comprised a hospital sample of 106 patients with epilepsy who underwent the Mini International Neuropsychiatric Interview (MINI).
As well, an online community sample of 273 people with epilepsy completed the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E9) and the brief Epilepsy Anxiety Survey Instrument (brEASI).
The study, published in Epilepsy & Behaviour, found anxiety and depression rates were 31.1% and 28.3% in the hospital group and 56.4% and 52.3% in the community group.
Coexisting anxiety and depression were high in both groups.
“From the hospital sample, 70% (23/33) of those with an anxiety disorder also met criteria for a depressive disorder and 76% (23/30) of those with a depressive disorder met criteria for an anxiety disorder,” the study said.
“The results from the community sample were similar with 74% (114/154) and 79% (114/143) of those with clinical symptoms of anxiety and depression (respectively), also scoring above the diagnostic cut-point on the other instrument.”
The study also found that of those identified with anxiety or depression, between 36% and 69% had not previously received that diagnosis.
Not surprisingly then, only about a third of people with anxiety and about half of those with depression had ever received treatment such as pharmacological or psychological therapies.
The researchers, led by clinical psychologist Dr Amelia Scott from Macquarie University, said routine screening for anxiety and depression in people with epilepsy was encouraged.
However while there was growing evidence for the benefit of treatment such as antidepressants and CBT for depression in epilepsy, the corresponding evidence for anti-anxiety treatment was still limited.
More research was required to understand and address the reasons why people with epilepsy were not accessing treatment.
“There are numerous barriers to accessing psychological treatment in the general population, such as financial and time constraints, and difficulties physically accessing such services. Such barriers appear to be especially pronounced in people with epilepsy, given many are unable to drive and/or the presence of frequent seizures.”