Occurrence and clinical correlates of depressive symptoms in adults with epilepsy: A study in Georgia

OBJECTIVE: To evaluate the occurrence, clinical correlates, and screening accuracy of depressive symptoms (DS) among adults with epilepsy in Georgia, a country with limited mental health resources. METHODS: We conducted a cross-sectional study in adults with epilepsy attending a tertiary care center. We assessed DS using two validated tools: the Beck Depression Inventory-II (BDI-II) and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), combined with comprehensive clinical and demographic data. RESULTS: Two hundred and seven adults were included, and DS were identified in 47% using the BDI-II and 22% using the NDDI-E, with moderate agreement between the scales (Cohen's κ = 0.469). DS were associated with later epilepsy onset (median 15.0 vs. 13.5 years), frontal lobe epilepsy (26.3% vs. 8.3%), polytherapy with older ASMs (60.7% vs. 42.3%), and ongoing seizures. SIGNIFICANCE: DS represent a substantial psychiatric burden in adults with epilepsy in Georgia, influenced by epilepsy-related factors and limitations of screening tools. These findings underscore the need for integrated mental health services and routine DS screening in epilepsy care. Longitudinal studies are warranted to clarify causal relationships and inform culturally tailored interventions. PLAIN LANGUAGE SUMMARY: Many people with epilepsy have low mood, but this is often missed and untreated. A recent study in Georgia found that nearly half of people with epilepsy have signs of very low mood. Those who were having regular seizures or taking more medication were more likely to struggle with low mood. In contrast, people who do not have seizures or whose seizures started on the brain's right side showed fewer low mood signs. These findings show that checking mood is just as important as treating their seizures. Routine mental health checks should be part of epilepsy consultations.