Contrary to the widespread belief that depressive disorders are more common than anxiety disorders
among people with epilepsy, these psychiatric comorbidities appear to have equivalent prevalence, according
to research published online ahead of print May 3 in
Epilepsia. In addition, variability in the observed prevalence of anxiety disorders in previous studies partly results from the method of diagnosis.
“These findings also challenge widely held assumptions that psychiatric comorbidity is more common
in people with drug-resistant epilepsy,” said Amelia J.
Scott, a PhD candidate at the University of Sydney.
Comorbid anxiety and depressive disorders are highly
prevalent in patients with epilepsy, compared with the
general population. The prevalence of anxiety disorders
reported in previous studies of people with epilepsy has
been highly variable, however. Ms. Scott and colleagues
conducted a study to clarify the prevalence of anxiety
and depressive disorders in patients with epilepsy and
to determine which factors account for the variability in
estimates of these disorders’ prevalence.
The investigators searched electronic databases to
find studies that reported the prevalence of anxiety and
depressive disorders in people with epilepsy until July
2016. Journal articles or dissertations that reported on
current diagnoses of anxiety and depressive disorders
based on a structured diagnostic interview or a clinician evaluation were included. Clinician evaluations followed the Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition or the International Classification of Diseases, Tenth Revision or more recent.
The investigators excluded studies of participants
younger than 16. In addition, studies that reported
diagnoses of anxiety and depressive disorders using
self-report measures and studies that only reported a
depression diagnosis or only an anxiety diagnosis were
also excluded. Finally, researchers excluded studies if
recruitment was based on additional medical comorbid-
ity or on results of prescreening measures of distress.
Extracted data included the prevalence of anxiety
and depressive disorders and moderators of interest (eg,
method of diagnosis and prevalence of drug-resistant
epilepsy). Using these data, Ms. Scott and colleagues
conducted a meta-analysis of the overall pooled preva-
lence of anxiety and depressive disorders.
In all, 27 studies met the inclusion criteria. The
pooled prevalence of anxiety disorders was 20.2%,
and the pooled prevalence of depressive disorders was
22.9%. Ms. Scott and colleagues also observed that the
method of diagnosis significantly affected the observed
prevalence of anxiety disorders. The prevalence of anx-
iety disorders based on unstructured clinician assess-
ment was 8.1%, compared with a prevalence of 27.3%
based on a structured clinical interview. No signifi-
cant moderators of depressive disorder diagnosis were
“Future research should aim to improve the detec-
tion and management of comorbidities in people with
epilepsy, particularly anxiety disorders, which have
remained relatively neglected,” said Ms. Scott. “An im-
provement in our understanding, detection, and man-
agement of both anxiety and depressive disorders in
people with epilepsy is crucial to improve the quality
of life of people with epilepsy.” NR
Scott AJ, Sharpe L, Hunt C, Gandy M. Anxiety and depressive disorders in
people with epilepsy: A meta-analysis. Epilepsia. 2017 May 3 [Epub ahead
Anxiety and Depressive
Disorders May Be Equally
Prevalent in Patients With Epilepsy
The method of diagnosis significantly moderated the prevalence of anxiety disorders.