Determining treatment levels of comorbid psychiatric conditions in people with epilepsy attending selected local clinics in Lusaka, Zambia

Abstract

Background: Psychiatric co-morbidities occur more frequently in patients with epilepsy but are usually undertreated. Treatment of these disorders is key to reducing mortality via suicide and other causes. This study determined the levels of treatment of psychiatric comorbidities at clinics in Lusaka, Zambia.

Methodology: This was a cross-sectional study at 5 randomly selected clinics within Lusaka with 397 respondents. These were patients attending epilepsy clinic for over 6 months, aged 18years and older. The Brief psychiatric rating scale (BPRS) and a self-designed questionnaire for demographics and medical history were administered to determine how many needed treatment compared to those that were on actually treatment.

Results: Of the 397 participants enrolled, only 14(3.5%) had psychiatric disorders already diagnosed by the local staff and yet screening with BPRS showed that up to 158(39.8%) had comorbidity symptoms. 13(92.8%) of those pre-diagnosed with psychiatric comorbidity were on treatment. There was a significant association between male gender and psychiatry diagnosis (p=0.017).

Conclusion: The detection and treatment rate of psychiatric comorbidity in epilepsy stands at 3.5% of the epilepsy population and comorbidity prevalence at about 39%. Less than 10% of those eligible receive treatment.  This low treatment rate may contribute to poor treatment outcomes.

Keywords: Psychiatric comorbidity, detection, treatment