Depression and associated factors among people with epilepsy at Wolaita Sodo University Hospital, South Ethiopia

Depression and associated factors among people with epilepsy at Wolaita Sodo University Hospital, South Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Depression and associated factors among people with epilepsy at Wolaita Sodo University Hospital, South Ethiopia Tamene Berhanu, Niguse Yigzaw, Seblewongel Tinsae, Yohannes Mirkena, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4862772/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Epilepsy is the most common neurological disorder in the world and contributed to various psychiatric illnesses. Depression is one of the most frequent co morbid psychiatric disorders that affect the quality of life in patients with epilepsy. Despite this impact depression continues to be under-recognized and undertreated. Therefore this study amid to assess the magnitude of depression and its associated factors among patients with epilepsy at Wolaita sodo university hospital, South Ethiopia 2021. Methods A hospital based cross sectional study was conducted from April 2021-May 2021. A systematic random sampling technique was used to select 423 samples of patients with epilepsy and interviewer administrated structured questionnaires was employed. Patient Health Questionnaire with 9-items was used to assess depression. Logistic regression model was used to determine the association between the outcome and independent variables. A 95% CI and Odds ratio with corresponding p-value < 0.05 were used to determine the strength of association. Result The overall magnitude of depression among epileptic patients in this study was 49.2%. Educational status; unable to read and write (AOR = 3.43, 95%CI:1.09,10.7), being female (AOR = 2.54, 95%CI:1.43,4.52), perceived stigma (AOR = 5.96, 95%CI:2.88,12.3), poor social support (AOR = 2.88, 95%CI:1.28, 6.48), poor medication adherence (AOR = 4.60, 95%CI: 2.46,8.63), seizure frequency of 6 times per month (AOR = 5.59, 95%CI:1.72, 18.1) were independent predictors of depression among patients with epilepsy at p-value < 0.05. Conclusion and recommendation: In this study nearly half of the patient with epilepsy had depression. Educational status; unable to read and write, being female, perceived stigma, poor social support, poor medication adherence, seizure frequency of 6 times per month were independent predictors of depression among patients with epilepsy. Therefore screening depression in epileptic patients and appropriate management critically needed attention to reduce the effects of the problems. Depression Epilepsy Wolaita Sodo South Ethiopia Introduction Epilepsy is the most common neurological disorders characterized by recurrent seizures and abnormal electrical activity in the brain that causes an involuntary change in body movement or function, sensation, awareness, or behavior( 1 ). The presence of recurrent seizures may cause difficulties in physical, social, psychological and important areas of the patient’s life ( 2 ). Approximately 50 million people worldwide and the majority of whom (80–85%) live in developing countries affected by epilepsy( 3 , 4 ). In Ethiopia the prevalence rate between 45.2% and 49.3%. Which affects 5.2 per 1000 population with an estimation of 0.5% of patients with seizers in the past 1–2 years( 5 , 6 , 7 ). Depression is the most common psychiatric comorbidity in people with epilepsy and it affects 9.5 to 63% of epileptic patients ( 8 , 9 ). Depression defined by depressed mood, loss of interest or pleasure, feeling of worthlessness or inappropriate guilt, disturbed sleep and appetite, feeling of tiredness, and poor concentration for a minimum of two weeks( 10 , 11 ). Globally from the total people who suffer from epilepsy, ≈ 15–60% also experienced depression, 80% of them were exist in low-income regions and are often under recognized and undertreated ( 12 – 16 ). Depression in people with epilepsy leads significant burdens to the patients and their families. People with epilepsy have been experienced more psychological disorders than general population ( 17 , 18 ). Despite this burden and consequences, depression continues to be under-recognized and undertreated due to limited study of its impact on epileptic patients( 19 – 25 ). According to previous study factors for occurrence of depression among patients with epilepsy were female gender, low educational status ( 26 , 27 , 28 , 29 ), uncontrolled seizure( 25 ), presence of frequent seizures, long duration of epilepsy and poor compliance to antiepileptic drug( 22 ), cannot read and write ( 20 , 31 , 32 ), poor medication adherence, frequency of seizure, having developed perceived stigma, contagious belief, heritability belief & treatability belief of the patients was associated with co-morbid depression ( 30 , 33 , 34 , 35 ). Moreover, the magnitude of depression among epileptic patients was rarely studied in developing countries, despite the fact that there are factors in these countries that contribute it. Therefore this study amid to assess the magnitude of depression and its associated factors among patients with epilepsy at Wolaita sodo university hospital, South Ethiopia. Methods and Materials Study design, setting and period A study was conducted from April 15 to May 10 2021 at Wolaita Sodo University Hospital Psychiatry clinic, Wolaita Sodo, South Ethiopia. Wolaita sodo university teaching and referral hospital located in Wolaita Sodo town which is located at 380 km south from Addis Ababa. Wolaita Sodo University Teaching Referral Hospital (WSUTRH) is the only public teaching and referral hospital in Wolaita Zone which provides a broad range of medical services in its catchment area for about more than three million people. The hospital delivers different medical services for outpatients, emergency and inpatients for approximately 450–500 patients per day. In the hospital the psychiatry unit is giving neurological services with mental health services. Participants All sampled epileptic patients who attending at Wolaita sodo university hospital psychiatry clinic during the data collection period were included in the study and participants who critically ill to the extent of unable to communicate during data collection period were excluded from the study. Sample size and Sampling procedure Single population proportion formula was used to calculate the number of required sample for this study and the sample size was calculated by using 51.2% prevalence of depression among peoples with epilepsy attending at Selected Public Health Facilities of Bench Maji Zone, South Ethiopia, 0.512 P, 1.96 Z (standard normal distribution), 95% CI, ⍺=0.05, ( 31 ). By adding 10% non-response rate the final sampling size was 423. Systematic random sampling technique was used for the selection of study participants. The k value was calculated by dividing the total population to total sample size so, the sampling fraction is (868/423 ≈ 2). Hence, the sample interval was 2, study participants were chosen at regular K intervals up to required sample size. Data collection Tools Patient health question (PHQ-9 ) was used to assess depression. It is one of the most widely used self-report measures of depression. It is a reliable and valid measure of depression in a range of cultural groups and has been validated with psychiatric and non-psychiatric populations with Cronbach’s α range from 0.84–0.915 in most of the countries including Africa. In Ethiopia, it was validated in Amharic and Afan Oromo version with Cronbach’s α of 0.85, specificity (67%) and sensitivity (86%). PHQ-9 consists of 9 items, and each item four-point Likert scores (not at all ‘0’up to nearly every day ‘3’) to describe a specific behavioral manifestation of depression. A score ≥ 10 were considered as having depression ( 36 , 37 ). Perceived stigma was measured by using the KSSE which was developed and validated in Kilifi, Kenya with high internal consistency, Cronbach's 𝛼 of 0.91 and adopted to Ethiopia. It has three-point Likert scale which scored as "not at all" (score of 0), "sometimes" (score of 1), and "always" (score of 2). It has fifteen items and a total score was calculated by addition of all item scores. The 66th percentile was used to categorize the scores ( 38 , 39 ). Social support was assessed by Oslo 3-item social support scale, Oslo 3-item social support scale is a 3- item questionnaire commonly used to asses' social support. The scale asks about the ease of getting help from neighbors, the number of people the subjects can count on when there are serious problems, and the level of concern people show in what the subject is doing. A sum-index was obtained by adding the raw scores of the three items. The range is 3–14. The scores were interpreted as ; 3–8 (poor social support), 9–11 (moderate social support), and 12–14 (strong social support) ( 40 , 41 ). Medication non-adherence was assessed by using validated Morisky Medication Adherence Scale (MMAS) which consists of 8 items with a dichotomous response (yes/no) with questions asking the patient to respond "yes" or "no" responses to items 1–7 and a 5 point Likert response for the last item. A positive response indicates a problem with adherence. Therefore, higher scores indicate that a patient is least-adherent to medications. The total score for each patient is the summation of the scores in each item. According to MMAS good medication adherence is categorized as (MMAS < 3) and poor medication adherence (MMAS ≥ 3) ( 42 ). For screening of substance use, modified form of ASSIST was used which is developed by World Health Organization (WHO) an international group of substance abuse researchers to detect and manage substance use and related problems in primary and general medical care settings. Data collection procedure A structured face-to-face interviewer-administered questionnaire was used to gather data. Data was collected by three bachelors of Science degree in psychiatry and one mental health specialist under supervision of principal investigator. Data quality control The questionnaire was developed in English version and translated in to Amharic then back translated to English by experts and psychiatry professionals to check consistency. To assure the quality of data, training was given for data collector prior to the data collection time. Before the actual data collection, the questionnaire was tested on 5% of the total sample size (n = 21) epileptic patients at Hawassa university referral hospital. The principal investigator was supervising and distributing all necessary items for data collection on each data collection day, checking filled questionnaire for completeness, solve forwarded problems timely during data collection. Data processing and analysis Data was entered into Epi data Software version 4.6.0.2 and then it was exported and analyzed by using STATA version 14. Then, the data was analyzed to generate descriptive statistics: means, frequency, percentages and standard deviations, using STATA version 14. Logistic regression analysis was used to calculate adjusted odds ratios to control for confounding variables with 95% confidence interval. Bivariate analysis was done to get variables which have association with dependent variable and then variables with p-value less than 0.25 were entered to multivariable analysis. Odds ratio with 95% CI was computed and variables having p-value less than 0.05 in multivariable models were considered as significantly associated with the dependent variable. Results Socio-demographic Characteristics of the respondents Out of 423 participants 402 were completed interview with response rate 95%. In this study male respondents were 212(52.7%), greater than half of the respondents 243 (60.45%) were protestant by their religion, about 134(33.3%) of the study subjects have attended secondary education followed by Diploma and above 102(25.4%), out of 402 participants 172(42.79%) were married and more than half of them 215(53.48%) were urban residents (Table 1 ). Table 1 Distribution of participants by their socio demographic characteristics at Wolaita sodo University Hospital, south Ethiopia, 2021 (n = 402) Variables Frequency(n = 402) Percentage Sex Male 212 52.7 Female 190 47.3 Age (years) 18–24 24–34 115 179 28.6 44.5 35–44 > 45 91 17 22.6 4.23 Religion Orthodox Muslim Catholic Protestant 91 29 39 243 22.6 7.21 9.70 60.4 Educational level Can’t read and write Read and write only Primary school 43 49 74 10.7 12.1 18.4 Marital status Occupation Residence Secondary school Tertiary(college/university) Single Married/in union Divorced/ Separated Widowed/ widower Student Self-employee Government employee Unemployed House wife Urban Rural 134 102 159 172 32 39 96 130 120 26 30 215 187 33.3 25.3 39.5 42.8 7.96 9.70 23.8 32.3 29.8 6.47 7.46 53.4 46.5 Clinical, psychosocial and substance use characteristics of the respondents Regarding to clinical characteristics, among respondents 283(70.4%) had seizure frequency of 2–5 times/ month and 339(84.33%) of respondents had age at onset of illness greater than 18 years, of the participants 101(25.12%) had family history of mental illness and about 169 (42%) respondents had moderate social support. From the respondents 69(17.2%) and 55(13.7%) had life time and current substance use history respectively (Table 2 ). Table 2 Distribution of participants by their clinical, psychosocial and substance use characteristics at Wolaita sodo university hospital, 2021. Variables Categories Frequency (n = 402) Percentage Family history of mental illness Seizure frequency per month Age at onset of disease in years Duration of illness in years Treatment duration in years Social support Life time substance use history Substance use in the past 3 months Perceived stigma Cause of epilepsy Contagious Heritable Treatable By what means Anti-epileptic Drug Adherence Yes No 5 times 18 years 11 years 11 years Poor Moderate Strong Yes No Yes No Yes No I don't know Spiritual possession Evil eye Family history Others Yes No Yes No Yes No Prayer Traditional treatment Modern medicine Good Poor 101 301 78 283 41 10 53 339 258 114 30 287 92 23 144 169 89 69 333 55 347 116 286 240 60 14 81 7 105 297 146 256 376 26 9 5 388 251 151 25.1 74.9 19.4 70.4 10.2 2.49 13.2 84.3 64.2 28.4 7.46 71.4 22.9 5.72 35.8 42.0 22.1 17.2 82.8 13.7 86.3 28.9 71.1 59.7 14.9 3.48 20.2 1.74 26.1 73.9 36.3 63.7 93.5 6.47 2.24 1.24 96.5 62.4 37.6 Others indicates- Pathogens, Sinful act and Walks around garbage, walking along a river. Magnitude of Depression among epileptic patients In this study the magnitude of depression among people with epilepsy was found to be 49.2%. Finding of this research reviled that the prevalence of depression is higher in female than male patient living with epilepsy at Wolaita Sodo University Hospital, South Ethiopia. Factors associated with depression among people with epilepsy In bi-variable analysis sex, educational status, marital status, social support, seizure frequency, duration of illness, duration of treatment, contagious, heritable and treatability belief, anti-epileptic medication adherence and perceived stigma were associated with depression among people with epilepsy at p-value < 0.25. During multivariable analysis being female, being unable to read and write, having poor social support, seizure frequency, poor medication adherence and having perceived stigma were significantly associated with depression at p-value < 0.05(Table 3 ). Table 3 Bivariable and multivariable analysis of factors associated with depression among people with epilepsy at Wolaita sodo university hospital, 2021. Variables Depression COR (95% CI) AOR (95% CI) Yes No Sex Male Female Marital Status Single Married/in union Divorced/ Separated Widowed/ widower Educational status Can’t read and write Read and write only Primary school ( 1 – 8 ) Secondary school ( 9 – 12 ) Diploma and above Seizure Frequency 5 per month Contagious Belief Yes No Heritability Belief Yes No Treatable belief Yes No Duration of illness 11 years Treatment duration 11 years Social Support Poor Moderate Strong Stigma Yes No AED adherence Good Poor 82 130 116 74 77 82 72 100 24 8 25 14 33 10 29 20 36 38 61 73 39 63 18 60 147 136 33 8 75 30 123 174 94 52 104 152 179 197 19 7 107 151 75 39 16 14 127 160 61 31 10 13 116 28 59 110 23 66 99 187 99 17 82 169 116 35 1.00 2.48 (1.66, 3.71) 1.30(0.84, 2.01) 1.00 4.16(1.77, 9.80) 2.48(1.20, 5.10) 5.33 (2.36, 12.0) 2.34(1.16, 4.69) 1.53(0.83, 2.80) 1.34(0.79, 2.28) 1.00 1.00 3.60(2.02, 6.40) 13.7 (5.39, 35.0) 3.53(2.18, 5.72) 1.00 2.64(1.73, 4.02) 1.00 1.00 2.98(1.22, 7.27) 1.00 2.71(1.71, 4.29) 1.61(0.75, 3.44) 1.00 2.47(1.51, 4.05) 0.96(0.41, 2.28) 11.8(6.33, 22.2) 1.53(0.87, 2.72) 1.00 11(6.22, 19.4) 1.00 1.00 6.83(4.30, 10.3) 1.00 2.54(1.43, 4.52) ** 1.21(0.65, 2.26) 1.00 2.09(0.56, 7.77) 2.60(0.98, 6.92) 3.43(1.09, 10.7) * 0.75(0.26, 2.10) 0.87 (0.37, 2.04) 1.26(0.62, 2.57) 1.00 1.00 2.28(1.10, 4.70) 5.59(1.72, 18.1) ** 1.49(.67, 3.34) 1.00 1.19(0.59, 2.39) 1.00 1.00 0.60(0.13, 2.64) 1.00 1.74(0.54, 5.59) 3.58(0.23, 24.2) 1.00 0.83(0.23, 2.93) 0.27(0.01, 5.08) 2.88(1.28, 6.48) * 1.11(0.54, 2.28) 1.00 5.96(2.88, 12.3) ** 1.00 1.00 4.60(2.46, 8.63) ** NB. *:- p < 0.05 **:- p < 0.01 Discussion In this study the magnitude of depression among epileptic patient was 49.2%, which is in line with the study done in Northwest Ethiopia (45.2%) ( 4 ) and Nigeria (45%) ( 29 ). But the result of this study was higher than the study conducted in Mekelle Ethiopia(34.8%) ( 34 ), in Central Ethiopia(43.8%) ( 16 ), Thai-land (38.5%)( 43 ) and Egypt (25.5%) ( 44 ). The observed difference might be due to difference in data collection tools, cutoff points, study areas and cultures of the study participants. For instance, in the study conducted in Egypt, from the total study participants, 100 of them were healthy individuals taken for comparison which may lower the prevalence of depression. In Thai-land, Hospital Anxiety and Depression scale was used to evaluate depression with different cutoff point compared to our study; this difference can be lead to the deference in magnitude of depression among epileptic patients. In this study PWE who had seizure frequency of 6 and above were more than five times (AOR = 5.59, 95%= 1.72, 18.1) more likely to develop depression as compared to those patients who had seizure frequency less than 6 which is consistent with study conducted at Northwest Ethiopia( 4 ). The possible explanation for this linkage might be the symptomatic appearance of epilepsy is overt, sudden and not easy to realize, so this difficulty of realizing where and when the seizure come may associated with socially unacceptable sign such as loss of bladder control, foaming from the mouth and tongue biting. These signs may lead the patients with epilepsy to stigma, depression, anxiety and other social and psychological problems. Finding of this study investigated that being female was significantly associated with depression compared to male respondents which was consistent with the study carried out in Gaza( 45 )( 33 , 46 ). This association might be females face difficulty in performing normal activities of daily living, and they might face several risks or challenges regarding with reproductive activity and pregnancy. Furthermore, women with epilepsy can have hard time to making decision with regard to major life events such as marriage or bearing children. Thus, these consequences might increase depression among females. Those PWE who had perceived stigma were nearly six times (AOR = 5.96, 95% CI: 2.88, 12.3) more likely to develop depression than those people with epilepsy who had no perceived stigma. This finding supported by other studies conducted in south India( 47 ) and Addis Ababa, Ethiopia( 30 ). The possible explanation for this association could be lack of coping strategies to different seizure effect such as perceived negative social attitude as a result of unaccepted sign of seizure, or the subjects may not develop stigma resistance ability through their life that help them to cope up with different cultural belief, social stigma and the impact of the illness that contributed to felt stigma. The odds of developing depression among epileptic patients who had poor social support (AOR = 2.88, 95% CI = 1.28, 6.48) were nearly 3 times more likely when compared with patients who had strong social support which is evidenced by the studies from South West Ethiopia( 32 ). This association might be due to the fact that social isolation reduces social support, which can have undesirable influence on physical and mental well-being including depression. Finally this research reviled that those patients who cannot read and write had more than three times (AOR = 3.43, 95% CI = 1.09, 10.7) odds of developing depression as compared to those patients who had educational status of college and above. These findings were consistent with the previous studies from in India( 48 ) and Iran ( 49 ). This linkage could be due to the fact that those patients with lower educational status may have poor insight about their illness and stress coping mechanisms to their illness which has contribution for developing depression. Limitation of the study This research used a small sample size, which could affect the generalizability of the results in other study settings and the data was collected through interviewer administered questionnaire, there might have social desirability, interviewer and recall bias. Lastly shortage of financial support didn’t allow reaching all chronic follow up clinic like HIV, DM and HTN. Conclusions and Recommendation In this study, the magnitude of depression among PWE was found to be slightly higher than similar study. Having lower educational status, poor social support, seizure frequency, having poor medication adherence and having perceived stigma were factors associated with depression in PWE. Routine screening for depression among epileptic patients, education on medication adherence, strengthening social support and educational status of PWE strongly needed to reverse the effect of the problems and enhance quality of live. Abbreviations ASSIST - Alcohol, Smoking and Substance Involvement Screening Test, AOR : Adjusted Odd Ratio, CI -Confidence Interval, COR : Crude Odd Ratio, ETB - Ethiopian Birr, IRB - Institutional Review Board, ICCMH - Integrated Clinical and Community Mental Health, KSSE - Kilifi Stigma Scale for Epilepsy, MH - Mental Health, OSS - Oslo Social Support, PHQ -Patient Health Questionnaire, PWE - People with Epilepsy, STATA - Statistical Data, WSU - Wolaita Sodo University, WSUTRH - Wolaita Sodo University Teaching and Referral Hospital, WHO - World Health Organization. Declarations Consent for publication Not applicable. Availability of data and materials The data that support the findings of this study is available from the corresponding authors upon reasonable request. Competing interests The authors declared that they have no competing interests. Funding institution This research was funded by the University of Gondar. However, the University of Gondar has no role in the designing of the study and data collection, analysis, as well interpretation of data and in writing the manuscript. Acknowledgements The authors would like to thank University of Gondar and study participants for their commitment in giving study information. Ethical consideration Ethical clearance was obtained from Institutional Review Board (IRB) of University of Gondar. Detail information about the study was explained to all study participants in the information sheet. Each participant provided written informed consent; for those who can’t read and write the interviewer read the consent; and after they agreed to participate, informed consent was obtained by the use of their finger prints. Participants had the right not to participate in the study and even to withdraw in between explained in advance. 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J Am Sci. 2018;14(3):77–83. Ibrahim AW, Mukhtar YM, Sadique PK, Tahir BM, Olabisi AM, Bukar RI et al. A facility-based assessment of internalized stigma among patients with severe mental illnesses in Maiduguri, North-Eastern Nigeria. Int Neuropsychiatric Disease J. 2016:1–11. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986:67–74. Phabphal K, Sattawatcharawanich S, Sathirapunya P, Limapichart K. Anxiety and depression in Thai epileptic patients. Med J Med Association Thail. 2007;90(10):2010. Hamed SA, Metwaly NA-H, Hassan MM, Mohamed KA, Ahmad MA-R, Soliman AA-M et al. Depression in adults with epilepsy: relationship to psychobiological variables. World. 2012;1. Abu Sheer A. Depression among Epileptic Patients in Governmental Community Mental Health Centers in Gaza Strip. 2012. Onwuekwe I, Ekenze O, Bzeala-Adikaibe O, Ejekwu J. Depression in patients with epilepsy: a study from Enugu, South East Nigeria. Annals Med health Sci Res. 2012;2(1):10–3. Joseph N, Ray A, Bhat S, Herady M, Kumar A. Assessment of quality of life, stigma associated and self-management practices among patients suffering from epileptic seizures: A cross sectional study. J Neurosci Behav Health. 2011;3(7):91–8. Mehmedika-Suljić E. Presence of depressive disorder among patients with epilepsy in relation to the duration of illness and type of antiepileptic therapy. Med Arh. 2008;62(3):156–8. Zahiroddin AR, Shafiee-Kandjani AR, Ghoreishi FS. Depression rate among 18–40-year-old patients suffering from generalized tonic-clonic epilepsy referred to Neurology Clinics in an Iranian Hospital. Neurosciences. 2008;13(1):86–7. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4862772","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":337039866,"identity":"52423d27-755c-447e-81f4-6200d7335516","order_by":0,"name":"Tamene Berhanu","email":"data:image/png;base64,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","orcid":"","institution":"Wolaita Sodo University","correspondingAuthor":true,"prefix":"","firstName":"Tamene","middleName":"","lastName":"Berhanu","suffix":""},{"id":337039867,"identity":"7088258e-c61a-4fc9-ae92-4e2a0f5aed69","order_by":1,"name":"Niguse Yigzaw","email":"","orcid":"","institution":"University of Gondar","correspondingAuthor":false,"prefix":"","firstName":"Niguse","middleName":"","lastName":"Yigzaw","suffix":""},{"id":337039868,"identity":"7d899a9f-da0f-48e4-8d45-5f5f26fd8c01","order_by":2,"name":"Seblewongel Tinsae","email":"","orcid":"","institution":"University of Gondar","correspondingAuthor":false,"prefix":"","firstName":"Seblewongel","middleName":"","lastName":"Tinsae","suffix":""},{"id":337039869,"identity":"48195c36-2a86-4630-8011-5649a6b6e294","order_by":3,"name":"Yohannes Mirkena","email":"","orcid":"","institution":"University of Gondar","correspondingAuthor":false,"prefix":"","firstName":"Yohannes","middleName":"","lastName":"Mirkena","suffix":""},{"id":337039870,"identity":"930f7093-bb31-4a5f-848d-0d12086daed8","order_by":4,"name":"Asegid Belete","email":"","orcid":"","institution":"University of Gondar","correspondingAuthor":false,"prefix":"","firstName":"Asegid","middleName":"","lastName":"Belete","suffix":""}],"badges":[],"createdAt":"2024-08-05 14:40:51","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4862772/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4862772/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":61988639,"identity":"3cebd035-d1f7-4602-a3e5-0b15b8077d9a","added_by":"auto","created_at":"2024-08-08 02:12:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":744745,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4862772/v1/69d80539-fc49-4e60-a143-5f5d7e21e8fc.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Depression and associated factors among people with epilepsy at Wolaita Sodo University Hospital, South Ethiopia","fulltext":[{"header":"Introduction","content":"\u003cp\u003eEpilepsy is the most common neurological disorders characterized by recurrent seizures and abnormal electrical activity in the brain that causes an involuntary change in body movement or function, sensation, awareness, or behavior(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The presence of recurrent seizures may cause difficulties in physical, social, psychological and important areas of the patient\u0026rsquo;s life (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Approximately 50\u0026nbsp;million people worldwide and the majority of whom (80\u0026ndash;85%) live in developing countries affected by epilepsy(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). In Ethiopia the prevalence rate between 45.2% and 49.3%. Which affects 5.2 per 1000 population with an estimation of 0.5% of patients with seizers in the past 1\u0026ndash;2 years(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDepression is the most common psychiatric comorbidity in people with epilepsy and it affects 9.5 to 63% of epileptic patients (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Depression defined by depressed mood, loss of interest or pleasure, feeling of worthlessness or inappropriate guilt, disturbed sleep and appetite, feeling of tiredness, and poor concentration for a minimum of two weeks(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Globally from the total people who suffer from epilepsy, \u0026asymp; 15\u0026ndash;60% also experienced depression, 80% of them were exist in low-income regions and are often under recognized and undertreated (\u003cspan additionalcitationids=\"CR13 CR14 CR15\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Depression in people with epilepsy leads significant burdens to the patients and their families. People with epilepsy have been experienced more psychological disorders than general population (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Despite this burden and consequences, depression continues to be under-recognized and undertreated due to limited study of its impact on epileptic patients(\u003cspan additionalcitationids=\"CR20 CR21 CR22 CR23 CR24\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAccording to previous study factors for occurrence of depression among patients with epilepsy were female gender, low educational status (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e), uncontrolled seizure(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e), presence of frequent seizures, long duration of epilepsy and poor compliance to antiepileptic drug(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e), cannot read and write (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e), poor medication adherence, frequency of seizure, having developed perceived stigma, contagious belief, heritability belief \u0026amp; treatability belief of the patients was associated with co-morbid depression (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMoreover, the magnitude of depression among epileptic patients was rarely studied in developing countries, despite the fact that there are factors in these countries that contribute it. Therefore this study amid to assess the magnitude of depression and its associated factors among patients with epilepsy at Wolaita sodo university hospital, South Ethiopia.\u003c/p\u003e"},{"header":"Methods and Materials","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design, setting and period\u003c/h2\u003e \u003cp\u003eA study was conducted from April 15 to May 10 2021 at Wolaita Sodo University Hospital Psychiatry clinic, Wolaita Sodo, South Ethiopia. Wolaita sodo university teaching and referral hospital located in Wolaita Sodo town which is located at 380 km south from Addis Ababa. Wolaita Sodo University Teaching Referral Hospital (WSUTRH) is the only public teaching and referral hospital in Wolaita Zone which provides a broad range of medical services in its catchment area for about more than three million people. The hospital delivers different medical services for outpatients, emergency and inpatients for approximately 450\u0026ndash;500 patients per day. In the hospital the psychiatry unit is giving neurological services with mental health services.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eAll sampled epileptic patients who attending at Wolaita sodo university hospital psychiatry clinic during the data collection period were included in the study and participants who critically ill to the extent of unable to communicate during data collection period were excluded from the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSample size and Sampling procedure\u003c/h2\u003e \u003cp\u003eSingle population proportion formula was used to calculate the number of required sample for this study and the sample size was calculated by using 51.2% prevalence of depression among peoples with epilepsy attending at Selected Public Health Facilities of Bench Maji Zone, South Ethiopia, 0.512 P, 1.96 Z (standard normal distribution), 95% CI, ⍺=0.05, (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). By adding 10% non-response rate the final sampling size was 423. Systematic random sampling technique was used for the selection of study participants. The k value was calculated by dividing the total population to total sample size so, the sampling fraction is (868/423\u0026thinsp;\u0026asymp;\u0026thinsp;2). Hence, the sample interval was 2, study participants were chosen at regular K intervals up to required sample size.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData collection Tools\u003c/h2\u003e \u003cp\u003ePatient health question (PHQ-9\u003cb\u003e)\u003c/b\u003e was used to assess depression. It is one of the most widely used self-report measures of depression. It is a reliable and valid measure of depression in a range of cultural groups and has been validated with psychiatric and non-psychiatric populations with Cronbach\u0026rsquo;s α range from 0.84\u0026ndash;0.915 in most of the countries including Africa. In Ethiopia, it was validated in Amharic and Afan Oromo version with Cronbach\u0026rsquo;s α of 0.85, specificity (67%) and sensitivity (86%). PHQ-9 consists of 9 items, and each item four-point Likert scores (not at all \u0026lsquo;0\u0026rsquo;up to nearly every day \u0026lsquo;3\u0026rsquo;) to describe a specific behavioral manifestation of depression. A score\u0026thinsp;\u0026ge;\u0026thinsp;10 were considered as having depression (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePerceived stigma was measured by using the KSSE which was developed and validated in Kilifi, Kenya with high internal consistency, Cronbach's \u0026#120572; of 0.91 and adopted to Ethiopia. It has three-point Likert scale which scored as \"not at all\" (score of 0), \"sometimes\" (score of 1), and \"always\" (score of 2). It has fifteen items and a total score was calculated by addition of all item scores. The 66th percentile was used to categorize the scores (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSocial support was assessed by Oslo 3-item social support scale, Oslo 3-item social support scale is a 3- item questionnaire commonly used to asses' social support. The scale asks about the ease of getting help from neighbors, the number of people the subjects can count on when there are serious problems, and the level of concern people show in what the subject is doing. A sum-index was obtained by adding the raw scores of the three items. The range is 3\u0026ndash;14. The scores were interpreted as ; 3\u0026ndash;8 (poor social support), 9\u0026ndash;11 (moderate social support), and 12\u0026ndash;14 (strong social support) (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMedication non-adherence was assessed by using validated Morisky Medication Adherence Scale (MMAS) which consists of 8 items with a dichotomous response (yes/no) with questions asking the patient to respond \"yes\" or \"no\" responses to items 1\u0026ndash;7 and a 5 point Likert response for the last item. A positive response indicates a problem with adherence. Therefore, higher scores indicate that a patient is least-adherent to medications. The total score for each patient is the summation of the scores in each item. According to MMAS good medication adherence is categorized as (MMAS\u0026thinsp;\u0026lt;\u0026thinsp;3) and poor medication adherence (MMAS\u0026thinsp;\u0026ge;\u0026thinsp;3) (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFor screening of substance use, modified form of ASSIST was used which is developed by World Health Organization (WHO) an international group of substance abuse researchers to detect and manage substance use and related problems in primary and general medical care settings.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eData collection procedure\u003c/h2\u003e \u003cp\u003eA structured face-to-face interviewer-administered questionnaire was used to gather data. Data was collected by three bachelors of Science degree in psychiatry and one mental health specialist under supervision of principal investigator.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData quality control\u003c/h2\u003e \u003cp\u003eThe questionnaire was developed in English version and translated in to Amharic then back translated to English by experts and psychiatry professionals to check consistency. To assure the quality of data, training was given for data collector prior to the data collection time. Before the actual data collection, the questionnaire was tested on 5% of the total sample size (n\u0026thinsp;=\u0026thinsp;21) epileptic patients at Hawassa university referral hospital. The principal investigator was supervising and distributing all necessary items for data collection on each data collection day, checking filled questionnaire for completeness, solve forwarded problems timely during data collection.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData processing and analysis\u003c/h2\u003e \u003cp\u003eData was entered into Epi data Software version 4.6.0.2 and then it was exported and analyzed by using STATA version 14. Then, the data was analyzed to generate descriptive statistics: means, frequency, percentages and standard deviations, using STATA version 14. Logistic regression analysis was used to calculate adjusted odds ratios to control for confounding variables with 95% confidence interval. Bivariate analysis was done to get variables which have association with dependent variable and then variables with p-value less than 0.25 were entered to multivariable analysis. Odds ratio with 95% CI was computed and variables having p-value less than 0.05 in multivariable models were considered as significantly associated with the dependent variable.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic Characteristics of the respondents\u003c/h2\u003e \u003cp\u003eOut of 423 participants 402 were completed interview with response rate 95%. In this study male respondents were 212(52.7%), greater than half of the respondents 243 (60.45%) were protestant by their religion, about 134(33.3%) of the study subjects have attended secondary education followed by Diploma and above 102(25.4%), out of 402 participants 172(42.79%) were married and more than half of them 215(53.48%) were urban residents (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of participants by their socio demographic characteristics at Wolaita sodo University Hospital, south Ethiopia, 2021 (n\u0026thinsp;=\u0026thinsp;402)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency(n\u0026thinsp;=\u0026thinsp;402)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u0026ndash;24\u003c/p\u003e \u003cp\u003e24\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115\u003c/p\u003e \u003cp\u003e179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003cp\u003e44.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003cp\u003e\u0026gt;\u0026thinsp;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91\u003c/p\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.6\u003c/p\u003e \u003cp\u003e4.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOrthodox\u003c/p\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003cp\u003eCatholic\u003c/p\u003e \u003cp\u003eProtestant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91\u003c/p\u003e \u003cp\u003e29\u003c/p\u003e \u003cp\u003e39\u003c/p\u003e \u003cp\u003e243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.6\u003c/p\u003e \u003cp\u003e7.21\u003c/p\u003e \u003cp\u003e9.70\u003c/p\u003e \u003cp\u003e60.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducational level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCan\u0026rsquo;t read and write\u003c/p\u003e \u003cp\u003eRead and write only\u003c/p\u003e \u003cp\u003ePrimary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43\u003c/p\u003e \u003cp\u003e49\u003c/p\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.7\u003c/p\u003e \u003cp\u003e12.1\u003c/p\u003e \u003cp\u003e18.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003cp\u003eResidence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary school\u003c/p\u003e \u003cp\u003eTertiary(college/university)\u003c/p\u003e \u003cp\u003eSingle Married/in union Divorced/ Separated\u003c/p\u003e \u003cp\u003eWidowed/ widower\u003c/p\u003e \u003cp\u003eStudent\u003c/p\u003e \u003cp\u003eSelf-employee Government employee\u003c/p\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003cp\u003eHouse wife\u003c/p\u003e \u003cp\u003eUrban\u003c/p\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e134\u003c/p\u003e \u003cp\u003e102\u003c/p\u003e \u003cp\u003e159\u003c/p\u003e \u003cp\u003e172\u003c/p\u003e \u003cp\u003e32\u003c/p\u003e \u003cp\u003e39\u003c/p\u003e \u003cp\u003e96\u003c/p\u003e \u003cp\u003e130\u003c/p\u003e \u003cp\u003e120\u003c/p\u003e \u003cp\u003e26\u003c/p\u003e \u003cp\u003e30\u003c/p\u003e \u003cp\u003e215\u003c/p\u003e \u003cp\u003e187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003cp\u003e25.3\u003c/p\u003e \u003cp\u003e39.5\u003c/p\u003e \u003cp\u003e42.8\u003c/p\u003e \u003cp\u003e7.96\u003c/p\u003e \u003cp\u003e9.70\u003c/p\u003e \u003cp\u003e23.8\u003c/p\u003e \u003cp\u003e32.3\u003c/p\u003e \u003cp\u003e29.8\u003c/p\u003e \u003cp\u003e6.47\u003c/p\u003e \u003cp\u003e7.46\u003c/p\u003e \u003cp\u003e53.4\u003c/p\u003e \u003cp\u003e46.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eClinical, psychosocial and substance use characteristics of the respondents\u003c/h2\u003e \u003cp\u003eRegarding to clinical characteristics, among respondents 283(70.4%) had seizure frequency of 2\u0026ndash;5 times/ month and 339(84.33%) of respondents had age at onset of illness greater than 18 years, of the participants 101(25.12%) had family history of mental illness and about 169 (42%) respondents had moderate social support. From the respondents 69(17.2%) and 55(13.7%) had life time and current substance use history respectively (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of participants by their clinical, psychosocial and substance use characteristics at Wolaita sodo university hospital, 2021.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n\u0026thinsp;=\u0026thinsp;402)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily history of\u003c/p\u003e \u003cp\u003emental illness\u003c/p\u003e \u003cp\u003eSeizure frequency\u003c/p\u003e \u003cp\u003eper month\u003c/p\u003e \u003cp\u003eAge at onset of\u003c/p\u003e \u003cp\u003edisease in years\u003c/p\u003e \u003cp\u003eDuration of illness\u003c/p\u003e \u003cp\u003ein years\u003c/p\u003e \u003cp\u003eTreatment duration\u003c/p\u003e \u003cp\u003ein years\u003c/p\u003e \u003cp\u003eSocial support\u003c/p\u003e \u003cp\u003eLife time substance\u003c/p\u003e \u003cp\u003euse history\u003c/p\u003e \u003cp\u003eSubstance use in the\u003c/p\u003e \u003cp\u003epast 3 months\u003c/p\u003e \u003cp\u003ePerceived stigma\u003c/p\u003e \u003cp\u003eCause of epilepsy\u003c/p\u003e \u003cp\u003eContagious\u003c/p\u003e \u003cp\u003eHeritable\u003c/p\u003e \u003cp\u003eTreatable\u003c/p\u003e \u003cp\u003eBy what means\u003c/p\u003e \u003cp\u003eAnti-epileptic Drug\u003c/p\u003e \u003cp\u003eAdherence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2 times\u003c/p\u003e \u003cp\u003e2\u0026ndash;5 times\u003c/p\u003e\u003cp\u003e\u0026gt;\u0026thinsp;5 times\u003c/p\u003e\u003cp\u003e\u0026lt;\u0026thinsp;11 years\u003c/p\u003e \u003cp\u003e11\u0026ndash;17 years\u003c/p\u003e\u003cp\u003e\u0026gt;\u0026thinsp;18 years\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5 year\u003c/p\u003e \u003cp\u003e5\u0026ndash;10 years\u003c/p\u003e\u003cp\u003e\u0026gt;\u0026thinsp;11 years\u003c/p\u003e\u003cp\u003e\u0026lt;\u0026thinsp;5 years\u003c/p\u003e \u003cp\u003e5\u0026ndash;11 years\u003c/p\u003e\u003cp\u003e\u0026gt;\u0026thinsp;11 years\u003c/p\u003e \u003cp\u003ePoor\u003c/p\u003e\u003cp\u003eModerate\u003c/p\u003e\u003cp\u003eStrong\u003c/p\u003e\u003cp\u003eYes No\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eI don't know\u003c/p\u003e\u003cp\u003eSpiritual possession\u003c/p\u003e\u003cp\u003eEvil eye\u003c/p\u003e\u003cp\u003eFamily history\u003c/p\u003e\u003cp\u003eOthers\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003ePrayer\u003c/p\u003e\u003cp\u003eTraditional treatment\u003c/p\u003e\u003cp\u003eModern medicine\u003c/p\u003e\u003cp\u003eGood\u003c/p\u003e\u003cp\u003ePoor\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003cp\u003e301\u003c/p\u003e \u003cp\u003e78\u003c/p\u003e \u003cp\u003e283\u003c/p\u003e \u003cp\u003e41\u003c/p\u003e \u003cp\u003e10\u003c/p\u003e \u003cp\u003e53\u003c/p\u003e \u003cp\u003e339\u003c/p\u003e \u003cp\u003e258\u003c/p\u003e \u003cp\u003e114\u003c/p\u003e \u003cp\u003e30\u003c/p\u003e \u003cp\u003e287\u003c/p\u003e \u003cp\u003e92\u003c/p\u003e \u003cp\u003e23\u003c/p\u003e \u003cp\u003e144\u003c/p\u003e \u003cp\u003e169\u003c/p\u003e \u003cp\u003e89\u003c/p\u003e \u003cp\u003e69 333\u003c/p\u003e \u003cp\u003e55\u003c/p\u003e \u003cp\u003e347\u003c/p\u003e \u003cp\u003e116\u003c/p\u003e \u003cp\u003e286\u003c/p\u003e \u003cp\u003e240\u003c/p\u003e \u003cp\u003e60\u003c/p\u003e \u003cp\u003e14\u003c/p\u003e \u003cp\u003e81\u003c/p\u003e \u003cp\u003e7\u003c/p\u003e \u003cp\u003e105\u003c/p\u003e \u003cp\u003e297\u003c/p\u003e \u003cp\u003e146\u003c/p\u003e \u003cp\u003e256\u003c/p\u003e \u003cp\u003e376\u003c/p\u003e \u003cp\u003e26\u003c/p\u003e \u003cp\u003e9\u003c/p\u003e \u003cp\u003e5\u003c/p\u003e \u003cp\u003e388\u003c/p\u003e \u003cp\u003e251\u003c/p\u003e \u003cp\u003e151\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.1\u003c/p\u003e \u003cp\u003e74.9\u003c/p\u003e \u003cp\u003e19.4\u003c/p\u003e \u003cp\u003e70.4\u003c/p\u003e \u003cp\u003e10.2\u003c/p\u003e \u003cp\u003e2.49\u003c/p\u003e \u003cp\u003e13.2\u003c/p\u003e \u003cp\u003e84.3\u003c/p\u003e \u003cp\u003e64.2\u003c/p\u003e \u003cp\u003e28.4\u003c/p\u003e \u003cp\u003e7.46\u003c/p\u003e \u003cp\u003e71.4\u003c/p\u003e \u003cp\u003e22.9\u003c/p\u003e \u003cp\u003e5.72\u003c/p\u003e \u003cp\u003e35.8\u003c/p\u003e \u003cp\u003e42.0\u003c/p\u003e \u003cp\u003e22.1\u003c/p\u003e \u003cp\u003e17.2\u003c/p\u003e \u003cp\u003e82.8\u003c/p\u003e \u003cp\u003e13.7\u003c/p\u003e \u003cp\u003e86.3\u003c/p\u003e \u003cp\u003e28.9\u003c/p\u003e \u003cp\u003e71.1\u003c/p\u003e \u003cp\u003e59.7\u003c/p\u003e \u003cp\u003e14.9\u003c/p\u003e \u003cp\u003e3.48\u003c/p\u003e \u003cp\u003e20.2\u003c/p\u003e \u003cp\u003e1.74\u003c/p\u003e \u003cp\u003e26.1\u003c/p\u003e \u003cp\u003e73.9\u003c/p\u003e \u003cp\u003e36.3\u003c/p\u003e \u003cp\u003e63.7\u003c/p\u003e \u003cp\u003e93.5\u003c/p\u003e \u003cp\u003e6.47\u003c/p\u003e \u003cp\u003e2.24\u003c/p\u003e \u003cp\u003e1.24\u003c/p\u003e \u003cp\u003e96.5\u003c/p\u003e \u003cp\u003e62.4\u003c/p\u003e \u003cp\u003e37.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cb\u003eOthers indicates-\u003c/b\u003ePathogens, Sinful act and Walks around garbage, walking along a river.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eMagnitude of Depression among epileptic patients\u003c/h2\u003e \u003cp\u003eIn this study the magnitude of depression among people with epilepsy was found to be 49.2%. Finding of this research reviled that the prevalence of depression is higher in female than male patient living with epilepsy at Wolaita Sodo University Hospital, South Ethiopia.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eFactors associated with depression among people with epilepsy\u003c/h2\u003e \u003cp\u003eIn bi-variable analysis sex, educational status, marital status, social support, seizure frequency, duration of illness, duration of treatment, contagious, heritable and treatability belief, anti-epileptic medication adherence and perceived stigma were associated with depression among people with epilepsy at p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.25. During multivariable analysis being female, being unable to read and write, having poor social support, seizure frequency, poor medication adherence and having perceived stigma were significantly associated with depression at p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05(Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariable and multivariable analysis of factors associated with depression among people with epilepsy at Wolaita sodo university hospital, 2021.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eYes No\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003cp\u003eMarital Status\u003c/p\u003e \u003cp\u003eSingle\u003c/p\u003e \u003cp\u003eMarried/in union\u003c/p\u003e \u003cp\u003eDivorced/ Separated\u003c/p\u003e \u003cp\u003eWidowed/ widower\u003c/p\u003e \u003cp\u003eEducational status\u003c/p\u003e \u003cp\u003eCan\u0026rsquo;t read and write\u003c/p\u003e \u003cp\u003eRead and write only\u003c/p\u003e \u003cp\u003ePrimary school (\u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5 CR6 CR7\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eSecondary school (\u003cspan additionalcitationids=\"CR10 CR11\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eDiploma and above\u003c/p\u003e \u003cp\u003eSeizure Frequency\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2 per month\u003c/p\u003e \u003cp\u003e2\u0026ndash;5 per month\u003c/p\u003e \u003cp\u003e\u0026gt;\u0026thinsp;5 per month\u003c/p\u003e \u003cp\u003eContagious Belief\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eHeritability Belief\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eTreatable belief\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eDuration of illness\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5 years\u003c/p\u003e \u003cp\u003e5\u0026ndash;10 years\u003c/p\u003e\u003cp\u003e\u0026gt;\u0026thinsp;11 years\u003c/p\u003e \u003cp\u003eTreatment duration\u003c/p\u003e\u003cp\u003e\u0026lt;\u0026thinsp;5 years\u003c/p\u003e \u003cp\u003e5\u0026ndash;11 years\u003c/p\u003e\u003cp\u003e\u0026gt;11 years\u003c/p\u003e \u003cp\u003eSocial Support\u003c/p\u003e\u003cp\u003ePoor\u003c/p\u003e\u003cp\u003eModerate\u003c/p\u003e\u003cp\u003eStrong\u003c/p\u003e\u003cp\u003eStigma\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eAED adherence\u003c/p\u003e\u003cp\u003eGood\u003c/p\u003e\u003cp\u003ePoor\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82 130 116 74\u003c/p\u003e \u003cp\u003e77 82\u003c/p\u003e \u003cp\u003e72 100\u003c/p\u003e \u003cp\u003e24 8\u003c/p\u003e \u003cp\u003e25 14\u003c/p\u003e \u003cp\u003e33 10 29 20 36 38 61 73 39 63\u003c/p\u003e \u003cp\u003e18 60\u003c/p\u003e \u003cp\u003e147 136\u003c/p\u003e \u003cp\u003e33 8\u003c/p\u003e \u003cp\u003e75 30\u003c/p\u003e \u003cp\u003e123 174\u003c/p\u003e \u003cp\u003e94 52\u003c/p\u003e \u003cp\u003e104 152\u003c/p\u003e \u003cp\u003e179 197\u003c/p\u003e \u003cp\u003e19 7\u003c/p\u003e \u003cp\u003e107 151\u003c/p\u003e \u003cp\u003e75 39\u003c/p\u003e \u003cp\u003e16 14\u003c/p\u003e \u003cp\u003e127 160\u003c/p\u003e \u003cp\u003e61 31\u003c/p\u003e \u003cp\u003e10 13\u003c/p\u003e \u003cp\u003e116 28\u003c/p\u003e \u003cp\u003e59 110\u003c/p\u003e \u003cp\u003e23 66\u003c/p\u003e \u003cp\u003e99 187\u003c/p\u003e \u003cp\u003e99 17\u003c/p\u003e \u003cp\u003e82 169\u003c/p\u003e \u003cp\u003e116 35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e2.48 (1.66, 3.71)\u003c/p\u003e \u003cp\u003e1.30(0.84, 2.01)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e4.16(1.77, 9.80)\u003c/p\u003e \u003cp\u003e2.48(1.20, 5.10)\u003c/p\u003e \u003cp\u003e5.33 (2.36, 12.0)\u003c/p\u003e \u003cp\u003e2.34(1.16, 4.69)\u003c/p\u003e \u003cp\u003e1.53(0.83, 2.80)\u003c/p\u003e \u003cp\u003e1.34(0.79, 2.28)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e3.60(2.02, 6.40)\u003c/p\u003e \u003cp\u003e13.7 (5.39, 35.0)\u003c/p\u003e \u003cp\u003e3.53(2.18, 5.72)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e2.64(1.73, 4.02)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e2.98(1.22, 7.27)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e2.71(1.71, 4.29)\u003c/p\u003e \u003cp\u003e1.61(0.75, 3.44)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e2.47(1.51, 4.05)\u003c/p\u003e \u003cp\u003e0.96(0.41, 2.28)\u003c/p\u003e \u003cp\u003e11.8(6.33, 22.2)\u003c/p\u003e \u003cp\u003e1.53(0.87, 2.72)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e11(6.22, 19.4)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e6.83(4.30, 10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e\u003cb\u003e2.54(1.43, 4.52)\u003c/b\u003e**\u003c/p\u003e \u003cp\u003e1.21(0.65, 2.26)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e2.09(0.56, 7.77)\u003c/p\u003e \u003cp\u003e2.60(0.98, 6.92)\u003c/p\u003e \u003cp\u003e\u003cb\u003e3.43(1.09, 10.7)\u003c/b\u003e*\u003c/p\u003e \u003cp\u003e0.75(0.26, 2.10)\u003c/p\u003e \u003cp\u003e0.87 (0.37, 2.04)\u003c/p\u003e \u003cp\u003e1.26(0.62, 2.57)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e2.28(1.10, 4.70)\u003c/p\u003e \u003cp\u003e\u003cb\u003e5.59(1.72, 18.1)\u003c/b\u003e**\u003c/p\u003e \u003cp\u003e1.49(.67, 3.34)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e1.19(0.59, 2.39)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e0.60(0.13, 2.64)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e1.74(0.54, 5.59)\u003c/p\u003e \u003cp\u003e3.58(0.23, 24.2)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e0.83(0.23, 2.93)\u003c/p\u003e \u003cp\u003e0.27(0.01, 5.08)\u003c/p\u003e \u003cp\u003e\u003cb\u003e2.88(1.28, 6.48)\u003c/b\u003e*\u003c/p\u003e \u003cp\u003e1.11(0.54, 2.28)\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e\u003cb\u003e5.96(2.88, 12.3)\u003c/b\u003e**\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e1.00\u003c/p\u003e \u003cp\u003e\u003cb\u003e4.60(2.46, 8.63)\u003c/b\u003e**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eNB. *:- p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 **:- p\u0026thinsp;\u0026lt;\u0026thinsp;0.01\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study the magnitude of depression among epileptic patient was 49.2%, which is in line with the study done in Northwest Ethiopia (45.2%) (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) and Nigeria (45%) (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). But the result of this study was higher than the study conducted in Mekelle Ethiopia(34.8%) (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e), in Central Ethiopia(43.8%) (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), Thai-land (38.5%)(\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e) and Egypt (25.5%) (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). The observed difference might be due to difference in data collection tools, cutoff points, study areas and cultures of the study participants. For instance, in the study conducted in Egypt, from the total study participants, 100 of them were healthy individuals taken for comparison which may lower the prevalence of depression. In Thai-land, Hospital Anxiety and Depression scale was used to evaluate depression with different cutoff point compared to our study; this difference can be lead to the deference in magnitude of depression among epileptic patients.\u003c/p\u003e \u003cp\u003eIn this study PWE who had seizure frequency of 6 and above were more than five times (AOR\u0026thinsp;=\u0026thinsp;5.59, 95%= 1.72, 18.1) more likely to develop depression as compared to those patients who had seizure frequency less than 6 which is consistent with study conducted at Northwest Ethiopia(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). The possible explanation for this linkage might be the symptomatic appearance of epilepsy is overt, sudden and not easy to realize, so this difficulty of realizing where and when the seizure come may associated with socially unacceptable sign such as loss of bladder control, foaming from the mouth and tongue biting. These signs may lead the patients with epilepsy to stigma, depression, anxiety and other social and psychological problems.\u003c/p\u003e \u003cp\u003eFinding of this study investigated that being female was significantly associated with depression compared to male respondents which was consistent with the study carried out in Gaza(\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e)(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). This association might be females face difficulty in performing normal activities of daily living, and they might face several risks or challenges regarding with reproductive activity and pregnancy. Furthermore, women with epilepsy can have hard time to making decision with regard to major life events such as marriage or bearing children. Thus, these consequences might increase depression among females.\u003c/p\u003e \u003cp\u003eThose PWE who had perceived stigma were nearly six times (AOR\u0026thinsp;=\u0026thinsp;5.96, 95% CI: 2.88, 12.3) more likely to develop depression than those people with epilepsy who had no perceived stigma. This finding supported by other studies conducted in south India(\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e) and Addis Ababa, Ethiopia(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). The possible explanation for this association could be lack of coping strategies to different seizure effect such as perceived negative social attitude as a result of unaccepted sign of seizure, or the subjects may not develop stigma resistance ability through their life that help them to cope up with different cultural belief, social stigma and the impact of the illness that contributed to felt stigma.\u003c/p\u003e \u003cp\u003eThe odds of developing depression among epileptic patients who had poor social support (AOR\u0026thinsp;=\u0026thinsp;2.88, 95% CI\u0026thinsp;=\u0026thinsp;1.28, 6.48) were nearly 3 times more likely when compared with patients who had strong social support which is evidenced by the studies from South West Ethiopia(\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). This association might be due to the fact that social isolation reduces social support, which can have undesirable influence on physical and mental well-being including depression.\u003c/p\u003e \u003cp\u003eFinally this research reviled that those patients who cannot read and write had more than three times (AOR\u0026thinsp;=\u0026thinsp;3.43, 95% CI\u0026thinsp;=\u0026thinsp;1.09, 10.7) odds of developing depression as compared to those patients who had educational status of college and above. These findings were consistent with the previous studies from in India(\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e) and Iran (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e). This linkage could be due to the fact that those patients with lower educational status may have poor insight about their illness and stress coping mechanisms to their illness which has contribution for developing depression.\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eLimitation of the study\u003c/h2\u003e \u003cp\u003eThis research used a small sample size, which could affect the generalizability of the results in other study settings and the data was collected through interviewer administered questionnaire, there might have social desirability, interviewer and recall bias. Lastly shortage of financial support didn\u0026rsquo;t allow reaching all chronic follow up clinic like HIV, DM and HTN.\u003c/p\u003e \u003c/div\u003e "},{"header":"Conclusions and Recommendation","content":"\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003cp\u003eIn this study, the magnitude of depression among PWE was found to be slightly higher than similar study. Having lower educational status, poor social support, seizure frequency, having poor medication adherence and having perceived stigma were factors associated with depression in PWE. Routine screening for depression among epileptic patients, education on medication adherence, strengthening social support and educational status of PWE strongly needed to reverse the effect of the problems and enhance quality of live.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eASSIST\u003c/strong\u003e- Alcohol, Smoking and Substance Involvement Screening Test, \u003cstrong\u003eAOR\u003c/strong\u003e: Adjusted Odd Ratio, \u003cstrong\u003eCI\u003c/strong\u003e-Confidence Interval, \u003cstrong\u003eCOR\u003c/strong\u003e: Crude Odd Ratio, \u003cstrong\u003eETB\u003c/strong\u003e- Ethiopian Birr, \u003cstrong\u003eIRB\u003c/strong\u003e- Institutional Review Board, \u003cstrong\u003eICCMH\u003c/strong\u003e- Integrated Clinical and Community Mental Health, \u003cstrong\u003eKSSE\u003c/strong\u003e- Kilifi Stigma Scale for Epilepsy, \u003cstrong\u003eMH\u003c/strong\u003e- Mental Health, \u003cstrong\u003eOSS\u003c/strong\u003e- Oslo Social Support, \u003cstrong\u003ePHQ\u003c/strong\u003e-Patient Health Questionnaire, \u003cstrong\u003ePWE\u003c/strong\u003e- People with Epilepsy, \u003cstrong\u003eSTATA\u003c/strong\u003e- Statistical Data, \u003cstrong\u003eWSU\u003c/strong\u003e- Wolaita Sodo University, \u003cstrong\u003eWSUTRH\u003c/strong\u003e- Wolaita Sodo University Teaching and Referral Hospital, \u003cstrong\u003eWHO\u003c/strong\u003e- World Health Organization.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study is available from the corresponding authors upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declared that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding institution\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was funded by the University of Gondar. However, the University of Gondar has no role in the designing of the study and data collection, analysis, as well interpretation of data and in writing the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank University of Gondar and study participants for their commitment in giving study information.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical consideration\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance was obtained from Institutional Review Board (IRB) of University of Gondar. Detail information about the study was explained to all study participants in the information sheet. Each participant provided written informed consent; for those who can\u0026rsquo;t read and write the interviewer read the consent; and after they agreed to participate, informed consent was obtained by the use of their finger prints. Participants had the right not to participate in the study and even to withdraw in between explained in advance. The privacy and confidentiality of study participants\u0026rsquo; information was kept at every stage of data processing by excluding any personal identifiers in the questionnaire well explained. Finally participants who had depression after screening received appropriate treatment. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTB revised and edited the final manuscript; AB conceptualized the study, wrote the proposal, participated in data collection, analyzed the data and prepared the manuscript. NY, ST and YM revised the proposal, and reviewed subsequent drafts, approved the proposal. All authors read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eEngel J, Pedley TA, Aicardi J. Epilepsy: a comprehensive textbook. Lippincott Williams \u0026amp; Wilkins; 2008.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrganization WH. Epilepsy in the WHO Eastern Mediterranean region: bridging the gap. 2010.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEngel J Jr. Epilepsy in the world today: medical point of view. Epilepsia. 2002;43:12\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBifftu BB, Dachew BA, Tiruneh BT, Tebeje NB. Depression among people with epilepsy in Northwest Ethiopia: a cross-sectional institution based study. BMC Res Notes. 2015;8(1):1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNgugi AK, Bottomley C, Kleinschmidt I, Sander JW, Newton CR. Estimation of the burden of active and life-time epilepsy: a meta‐analytic approach. 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Epilepsy Behav. 2013;27(2):296\u0026ndash;300.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAziz-ur-Rehman Yousafzai AW, Yousafzai RT. Frequency of depression in epilepsy: a hospital based study. J Ayub Med Coll Abbottabad. 2009;21(2):21\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNidhinandana S, Chinvarun Y, Sithinamsuwan P, Udommongkol C, Suwantamee J, Wongmek W, et al. Prevalence of depression among epileptic patients at Phramongkutklao Hospital. Volume 90. JOURNAL-MEDICAL ASSOCIATION OF THAILAND; 2007. p. 32. 1.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStefanello S, Mar\u0026iacute;n-L\u0026eacute;on L, Fernandes PT, Li LM, Botega NJ. Depression and anxiety in a community sample with epilepsy in Brazil. Arq Neuropsiquiatr. 2011;69(2B):342\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSezibera V, Nyirasafari D. Incidence of depression in Epilepsy patients. Rwanda J. 2013;1(1):67\u0026ndash;77.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOgunrin OA, Obiabo YO. Depressive symptoms in patients with epilepsy: Analysis of self-rating and physician's assessment. Neurol India. 2010;58(4):565.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTegegne MT, Mossie TB, Awoke AA, Assaye AM, Gebrie BT, Eshetu DA. Depression and anxiety disorder among epileptic people at Amanuel Specialized Mental Hospital, Addis Ababa, Ethiopia. BMC Psychiatry. 2015;15(1):1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTadesse A, Anand S, Abera M. Prevalence of depression and its associated factors among adult epileptic patients following treatment at public health facilities of bench maji zone, south west Ethiopia, 2017 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEngidaw NA, Bacha L, Kenea A. Prevalence of depression and associated factors among epileptic patients at Ilu Ababore zone hospitals, South West Ethiopia, 2017: a cross\u0026ndash;sectional study. Ann Gen Psychiatry. 2020;19(1):1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTsegabrhan H, Negash A, Tesfay K, Abera M. Co-morbidity of depression and epilepsy in Jimma University specialized hospital, Southwest Ethiopia. Neurol India. 2014;62(6):649.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSeid J, Mebrahtu K. Prevalence and associated factors of depression among people with epilepsy in Mekelle, Tigray, Ethiopia, 2019. 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMesafint G, Shumet S, Habtamu Y, Fanta T, Molla G. Quality of Life and Associated Factors Among Patients with Epilepsy Attending Outpatient Department of Saint Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019. J Multidisciplinary Healthc. 2020;13:2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWoldetensay YK, Belachew T, Tesfaye M, Spielman K, Biesalski HK, Kantelhardt EJ, et al. Validation of the Patient Health Questionnaire (PHQ-9) as a screening tool for depression in pregnant women: Afaan Oromo version. PLoS ONE. 2018;13(2):e0191782.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGelaye B, Williams MA, Lemma S, Deyessa N, Bahretibeb Y, Shibre T, et al. Validity of the patient health questionnaire-9 for depression screening and diagnosis in East Africa. Psychiatry Res. 2013;210(2):653\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMbuba CK. Epilepsy Treatment Gap, Associated Risk Factors and Intervention Strategies in Kilifi. Kenya: Verlag nicht ermittelbar; 2011.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFanta T, Azale T, Assefa D, Getachew M. Prevalence and factors associated with perceived stigma among patients with epilepsy in Ethiopia. Psychiatry J. 2015;2015.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJemal K. Prevalence and correlates of co-morbid anxiety and depression among patients with dental disease on follow up at Saint Paul\u0026rsquo;s hospital millennium medical college, Addis Ababa, Ethiopia. J Am Sci. 2018;14(3):77\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIbrahim AW, Mukhtar YM, Sadique PK, Tahir BM, Olabisi AM, Bukar RI et al. A facility-based assessment of internalized stigma among patients with severe mental illnesses in Maiduguri, North-Eastern Nigeria. Int Neuropsychiatric Disease J. 2016:1\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMorisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986:67\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePhabphal K, Sattawatcharawanich S, Sathirapunya P, Limapichart K. Anxiety and depression in Thai epileptic patients. Med J Med Association Thail. 2007;90(10):2010.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHamed SA, Metwaly NA-H, Hassan MM, Mohamed KA, Ahmad MA-R, Soliman AA-M et al. Depression in adults with epilepsy: relationship to psychobiological variables. World. 2012;1.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbu Sheer A. Depression among Epileptic Patients in Governmental Community Mental Health Centers in Gaza Strip. 2012.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOnwuekwe I, Ekenze O, Bzeala-Adikaibe O, Ejekwu J. Depression in patients with epilepsy: a study from Enugu, South East Nigeria. Annals Med health Sci Res. 2012;2(1):10\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJoseph N, Ray A, Bhat S, Herady M, Kumar A. Assessment of quality of life, stigma associated and self-management practices among patients suffering from epileptic seizures: A cross sectional study. J Neurosci Behav Health. 2011;3(7):91\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMehmedika-Suljić E. Presence of depressive disorder among patients with epilepsy in relation to the duration of illness and type of antiepileptic therapy. Med Arh. 2008;62(3):156\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZahiroddin AR, Shafiee-Kandjani AR, Ghoreishi FS. Depression rate among 18\u0026ndash;40-year-old patients suffering from generalized tonic-clonic epilepsy referred to Neurology Clinics in an Iranian Hospital. Neurosciences. 2008;13(1):86\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Depression, Epilepsy, Wolaita Sodo, South Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-4862772/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4862772/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEpilepsy is the most common neurological disorder in the world and contributed to various psychiatric illnesses. Depression is one of the most frequent co morbid psychiatric disorders that affect the quality of life in patients with epilepsy. Despite this impact depression continues to be under-recognized and undertreated. Therefore this study amid to assess the magnitude of depression and its associated factors among patients with epilepsy at Wolaita sodo university hospital, South Ethiopia 2021.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA hospital based cross sectional study was conducted from April 2021-May 2021. A systematic random sampling technique was used to select 423 samples of patients with epilepsy and interviewer administrated structured questionnaires was employed. Patient Health Questionnaire with 9-items was used to assess depression. Logistic regression model was used to determine the association between the outcome and independent variables. A 95% CI and Odds ratio with corresponding p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were used to determine the strength of association.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e \u003cp\u003eThe overall magnitude of depression among epileptic patients in this study was 49.2%. Educational status; unable to read and write (AOR\u0026thinsp;=\u0026thinsp;3.43, 95%CI:1.09,10.7), being female (AOR\u0026thinsp;=\u0026thinsp;2.54, 95%CI:1.43,4.52), perceived stigma (AOR\u0026thinsp;=\u0026thinsp;5.96, 95%CI:2.88,12.3), poor social support (AOR\u0026thinsp;=\u0026thinsp;2.88, 95%CI:1.28, 6.48), poor medication adherence (AOR\u0026thinsp;=\u0026thinsp;4.60, 95%CI: 2.46,8.63), seizure frequency of 6 times per month (AOR\u0026thinsp;=\u0026thinsp;5.59, 95%CI:1.72, 18.1) were independent predictors of depression among patients with epilepsy at p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003ch2\u003eConclusion and recommendation:\u003c/h2\u003e \u003cp\u003eIn this study nearly half of the patient with epilepsy had depression. Educational status; unable to read and write, being female, perceived stigma, poor social support, poor medication adherence, seizure frequency of 6 times per month were independent predictors of depression among patients with epilepsy. Therefore screening depression in epileptic patients and appropriate management critically needed attention to reduce the effects of the problems.\u003c/p\u003e","manuscriptTitle":"Depression and associated factors among people with epilepsy at Wolaita Sodo University Hospital, South Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-08 02:04:17","doi":"10.21203/rs.3.rs-4862772/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8377d5d5-037d-4f04-a9a0-676879ce82b0","owner":[],"postedDate":"August 8th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-08-08T02:04:17+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-08 02:04:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4862772","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4862772","identity":"rs-4862772","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}