Psychosocial impairments among adults with epilepsy in a neurology clinic in Nigeria

Abstract

Objective: Psychosocial problems unattended to may compromise adequate control of seizures and elevate the risk of psychopathology. We assessed for psychosocial impairments and associated psychopathology in patients with epilepsy, with the hope that findings will help initiate formal psychosocial care for patients attending the neurology clinic. Methods: Consecutive patients with epilepsy seen at the neurology clinic that met the inclusion criteria and gave consent were interviewed in a 2 stage procedure. In the first stage patients were assessed with a semi-structured questionnaire containing psychosocial variables while probable psychiatric morbidity was assessed with General Health Questionnaire (GHQ-12). In the second stage psychiatric diagnoses were assessed with Schedule for Clinical Assessment in Neuropsychiatry (SCAN). Results: Many of the patients reported difficulties in at least one or more of the psychosocial domains assessed; areas of difficulty included: physical activity (52.4%), occupational activity (46.8%); finances (41.3%); stigma (33.3%); inadequate social support by relatives (31.7%), and perceived inadequate general adjustment (34.9%). Psychosocial factors significantly associated with increased rate of psychopathology included: being a woman, having low education; financial difficulties and limitations in physical activities while significant clinical factors included: having frequent fits and partial epilepsy. Multiple logistic regression analyses indicated that being a woman and having partial seizures were the most important predictors of psychopathology among the patients. Conclusion: This study has provided evidence of the need to introduce routine psychosocial care in our neurology clinic which hitherto did not carry out structured routine assessment of psychosocial problems in order to reduce risk of psychopathology.