Psychiatric Comorbidities Among Adolescents With Epilepsy Attending the Neurology Clinic at Kenyatta National Hospital

Abstract

Introduction: Epilepsy is a neurological condition characterized by abnormal electrical activities in different regions of the brain. According to a report by the World Health Organization (WHO) in 2018, close to fifty million individuals are affected by epilepsy on a global scale with eighty percent of them living in countries with low to middle income levels. The majority are children and adolescents who are at a high risk of developing psychiatric comorbidities. Epilepsy and its comorbidities reduce the quality of life of an individual. There is scarcity of data on psychiatric comorbidities among the adolescent population living with epilepsy in Kenya. Study objective: To determine the prevalence and associated factors of psychiatric comorbidities among adolescents with epilepsy attending the neurology clinic at Kenyatta National Hospital(KNH). Methodology: This was a cross sectional descriptive study which was conducted in the neurology clinic at Kenyatta National Hospital. Purposive sampling was used to recruit 137 participants. A researcher designed sociodemographic and clinical characteristics questionnaire and MINI-KID 7.0.2 were used. SPSS version 27.0 was used for data analysis. Both descriptive and inferential analysis were carried out. Demographic and clinical characteristics of epileptic adolescent patients recruited in the study were summarized descriptively using frequencies and percentages. The prevalence of a psychiatric comorbidity was calculated as a proportion of having at least one psychiatric comorbidity and expressed as a percentage. Bivariate and multivariable analysis were conducted using binary logistic regression. Variables with p≤0.05 from the bivariate analysis were subjected to multivariable analysis to determine independent factors associated with psychiatric comorbidity. Crude odds ratio and adjusted odds ratio were interpreted to explain the strength of association in bivariate and multivariate analysis respectively. Significance was determined at p<0.05 for all inferential analysis. xiii Results: A total of 137 adolescent patients with epilepsy were enrolled in the study. 59.9 % of the total respondents were male. The prevalence of psychiatric morbidity was 70.1% having at least one psychiatric comorbidity. The most common psychiatric comorbidities included depression (41.6%), social anxiety disorder (20.4%), ADHD (19.0%), panic disorder (18.2%) and Bipolar disorder (13.9%). Having had the diagnosis of epilepsy for a period of less than five years, AOR =3.15, 95%CI: 1.10 – 10.12, p =0.005, the use of combination drugs, AOR= 2.31, 95%CI: 1.21 – 10.11, p =0.046 and family history of psychiatric disorder, AOR = 13.7, 95%CI: 1.17 – 33.40, p =0.037 were associated with psychiatric comorbidity. Conclusion and recommendation: The findings illustrate the high burden of psychiatric comorbidity among adolescent patients with epilepsy, with 70.1% having at least one psychiatric comorbidity. Common comorbidities among this population included depression, social anxiety, ADHD, panic disorder and bipolar disorder. Family history of psychiatric disorder, duration of epilepsy diagnosis and use of combination prescription drugs for treatment of epilepsy have an impact on the mental health of adolescents with epilepsy. It is essential to incorporate early screening and management of psychiatric disorders into standard routine epilepsy care to enhance the quality of life for adolescent patients with epilepsy.