Determinants of depression and anxiety in patients with refractory epilepsy and cognitive problems

Background and Purpose: Few studies of psychopathology in patients with cognitive problems and refractory epilepsy (RE) have been performed. We aimed to assess depression, anxiety, and their determining factors in Bulgarian patients with RE and cognitive problems. Methods: We conducted a study based on questionnaires designed for people with intellectual disability (stigma scale, Glasgow Depression Scale, Glasgow Anxiety Scale) and a purposeful interview on clinical and social factors of 64 patients with RE and cognitive problems. Results: We found depression in 40.63% and anxiety in 71.43% of study participants. Depression correlated with female gender P < 0.01 (2 = 6.48), seizure type P < 0.05 (2 = 7.68), seizure severity P < 0.05 (2 = 9.04), educational level P < 0.05 (2 = 3.86), and stigma P < 0.01 (2 = 12.57). Seizure severity, gender, stigma, and educational level proved to be predictors of depression on multivariate regression analysis P < 0.001 (F = 12.08). Anxiety correlated with seizure severity P < 0.05 (2 = 8.65), focal neurological deficit P < 0.05 (2 = 5.91), stigma P < 0.05 (2 = 7.01), and depression P < 0.05 (2 = 5.31). Seizure severity and focal neurological deficit were the only predictors of anxiety on multivariate regression analysis P < 0.001 (F = 6.35). Conclusions: We have affirmed frequent anxiety and depression in patients with RE and cognitive problems and their clinical, social, and demographic determinants. The results from our study prove the necessity of a multidisciplinary approach to these patients.