Depression and situational anxiety are risk factors for noncompliance with medical treatment in adult patients with epilepsy in Kyrgyzstan

Abstract

To determine the severity of depression and anxiety in patients with different types of epilepsy, not treated with antidepressive drugs and anxiolytics and to make a correlation with antiepileptic drugs compliance. A case-control study was done in Kyrgyzstan, Bishkek City Clinic 1, in the group of interest patients with long term of all types of epilepsy were included and in control group we enrolled other neurological patients, free from seizures and epilepsy. We used clinical diagnosis of epilepsy, confirmed with EEG findings. Zung depression scale and Spilberger scale for the anxiety diagnostics were adapted to Kyrgyz language and applied. 65 patients were included in the study: 34 were with epilepsy. Of the total sample nearly 70.0% of participants had anxiety and 61% in epilepsy group. The most prevalent symptom of anxiety was “the expecting of seizures";” (67.6%). We found strong correlation between low educational level and the risk of pills withdrawal: (OR = 2.79, 95% CI = 1.04–3.05), but higher education was the risk for anxiety (OR = 3.1, 95% CI = 2.15–4.01). Patients using benzodiazepins were prone to withdraw it in long term more due to side effects (45%), compared to valproate group (11%). 28% patients with epilepsy were prone to withdraw pills due to moderate depression (OR = 4.35, 95% CI = 2.27–8.31). High level of situational anxiety and moderate level of depression were associated with lower compliance to antiepileptic regimen. Patients in Kyrgyzstan tend to adhere to pursuing alternative regimens (traditional medicine).