Investigating the prevalence of depression and factors influencing it in patients with depression in Bandar Abbas city

Master's Thesis in Psychology (M.A)

Trend: Clinical

Abstract

The aim of this research is to identify the prevalence of depression in patients with epilepsy. For this purpose, the researcher has estimated the level of depression in patients with epilepsy according to the gender, education level, age and economic status of the patients. The current evaluation research method is a descriptive research, in this way, a group of obsessive-compulsive patients is selected as the study group, then the symptoms of depression in this group are evaluated. The statistical population includes all obsessive-compulsive patients who refer to the brain and neurology clinics of Bandar Abbas city. Considering that the research method is evaluation, the sampling method is purposeful. As a result, 60 people were selected as sample people (study group) among the available ones. The data collection tool includes the Beck Depression Questionnaire and the Demographic Characteristics Questionnaire. This questionnaire contains questions, some of which are related to the age, gender, educational and economic status of the patients. In this questionnaire, the economic status of the families was categorized into 5 levels. which were very good, good, average, weak and very bad and were determined according to the attitude of the patients. And for data analysis, two methods of descriptive statistics and inferential statistics were used. In the descriptive statistics section, central and dispersion parameters, tables and graphs were discussed, and hypotheses were tested in the inferential statistics section. To test the hypotheses, non-parametric Kruskal-Wallis tests and one-group parametric t test were used using spss software. Finally, the results of the study showed that the prevalence of depression in epilepsy patients has a global rate and there is no significant difference at the alpha level of 0.05%. Also, in this study, gender, education level, economic status were correlated with the prevalence of depression in epilepsy patients, and no significant relationship was observed with age.

*Keywords: depressive disorder / prevalence / epilepsy

Epilepsy is one of the most common chronic neurological diseases and its prevalence is about 1% is mentioned (Kaplan Sadok[1], 2003).

Epilepsy is caused by abnormal electrical discharge caused by overstimulated neurons with depolarization after the synapse, the mechanisms responsible for this depolarization include, change of ion conduction, reduction of inhibition of the GABA medium nerve on the excitability of the brain cortex, increase of excitability of the brain cortex due to glutamate (Mario and Mendez[2], 2005). Epilepsy is a syndrome in which electrophysiological changes, structural and biochemical changes in the brain are observed, especially in the limbic system, temporal lobes and possibly frontal lobes. The mentioned changes may affect the emotional, behavioral, cognitive, and social performance of the addict. Although the psychopathology of epilepsy has not been precisely determined, the result of an increase in psychiatric disorders can be seen in this neurological disorder (Winkles [3], 2004).

The incidence of epilepsy in the elderly and children is higher than in other ages, and men are more involved than women (Andriol et al. [4], 2001). Studies conducted in the general population have stated that the prevalence of psychiatric disorders in epilepsy patients is twice as high as in non-epileptics (Gataziz et al. [5], 2004). The overall prevalence of mental disorders in chronic epilepsy has been mentioned as 50-60%. Among the various psychiatric disorders associated with epilepsy, maximum attention has been paid to depression, and other disorders have received less attention (Beinberg et al. [6], 2005).

There is a difference of opinion regarding the most common psychiatric disorder associated with epilepsy. Some studies have reported depression (Perrin et al.[7], 1996) and others anxiety disorder (Kaplan Siders et al.[8], 2005) as the most common disorder. Feelings of worthlessness, despair, sadness, and nervousness are more common in people with epilepsy than in non-epileptics (Strain et al. [9], 2005). The symptoms of interictal boredom and epileptic insanity are also among the psychiatric disorders reported in patients with epilepsy (Eswinkel et al. [10], 2005). It has been reported that suicidal thoughts are more common in these patients than in the general population (Kaplan Sadok et al., 2005).

The prevalence of depression in these patients is twice that of patients with other debilitating diseases. Depression is often not diagnosed or incompletely treated in these patients.Incomplete treatment of depression in these patients can clearly have important consequences (Andriol [11] et al., 2001). Anxiety can also have many adverse effects on the quality of life of people with epilepsy (Beinberg[13] et al., 2005). The existence of depression along with epilepsy has led to more use of outpatient and inpatient treatment services and higher cost of treatment (Lee et al. [14], 2005).

It has also been stated that the quality of life of epilepsy patients is more dependent on variables related to mental health than it is dependent on variables related to epilepsy (Guliam [15], 2005). Despite its great importance, depression in epilepsy sufferers is less diagnosed and treated (Jones et al., 2005). Doctors will be able to improve the outcomes of their patients through the evaluation and diagnosis of psychiatric problems of patients with epilepsy (Strain [16] et al., 2005).

More attention of health service providers to psychiatric disorders associated with epilepsy is mandatory (Blumero [17] et al., 1995).

Considering the inappropriate effects of psychiatric disorders on patients' lives and the need to pay attention to these disorders, the present study aims to determine the frequency of depression in patients with epilepsy and Also, the relationship between the frequency of the mentioned symptoms and some variables has been investigated. It will be all over the world (Mari and Lopez [18], 1998; from Ebrahimi, 2016). Patients with chronic medical disorders are significantly more at risk of developing this disease than other people, so that in some studies, the prevalence rate of 15-23 percent has been reported for it (Lee, 2007).

Depression is common among patients with epilepsy, but there are few studies regarding this disorder. (Mario et al.[19], 1986) compare the prevalence of depression in patients Outpatients related to disability and its phenomenology were investigated in clinical patients admitted to the hospital. The results of this research showed that 55% of 175 outpatients with epilepsy, and 30% of 70 cases of the comparative control group, suffered from depression, and 30% of the patients with epilepsy, compared to 7% of the control group, had attempted suicide in the past. Constipated patients had a history of hospitalization due to depression four times more than non-constipated patients. 16 patients had minor seizures, and 10 out of 11 patients were recorded with lateral brain waves focused on the left hemisphere. These results indicate a mental disorder caused by defective psychocerebral or limbic function (Mario et al., 1986).

In the early 20th century (Kraplin, [20] 1903) and then Bloomer described depression in obsessive-compulsive patients, which includes a polymorphous pattern of symptoms, including effective symptoms along with high mood irritability, and mixed with cheerful mood, fear, signs of anxiety, It was fatigue, pain and insomnia, they said.

Gastat also confirmed these observations. Bloomer coined the term "restlessness disorder or boredom between pregnancies" to name this type of depression in obese patients. and described its chronic course using periods free of recurrent symptoms that responded well to low doses of antidepressants (Blumer et al. [21], 1988).

The prevalence of major depression in the normal population has been estimated at 25 percent (Sadok and Sadok, [22] 2003), while this figure in epilepsy patients is four to five times the average rate in the community. (Jones et al. [23], 2005). Epilepsy along with depression leaves a deep impact and leads to a drop in daily performance and a decline in the patient's quality of life, a decrease in educational progress in affected children and adolescents (Towson et al. [24], 2008), a decrease in the marriage rate and an increase in the unemployment rate and seizures, high mortality (Wolsin et al. [25], 1999) and an increase in the need for medical treatment. Statistically, 1-5% of people in the society suffer from epilepsy and the possibility of contracting Epilepsy exists for everyone (Milani Far, 2013).

The rate of suicide in epilepsy patients is four to five times the normal population (Lambert [26], 1999).