The impact of a short depression and anxiety screening tool in epilepsy care in primary health care settings in Zambia.

Journal: The American journal of tropical medicine and hygiene

Volume: 89

Issue: 5

Year of Publication: 2013

Affiliated Institutions:  Department of Mental Health and Clinical Psychiatry, Chainama College of Health Sciences, Lusaka, Zambia; School of Nursing and Public Health University of Kwa Zulu Natal, Durban, South Africa; Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia; University of Rochester, Department of Neurology, Epilepsy Division, Rochester, New York.

Abstract summary 

Up to 60% of the 50 million persons with epilepsy (PWE) worldwide have depression and anxiety and 80% of PWE live in low-income regions. Common psychiatric comorbidities are often unrecognized and undertreated. We developed and validated a 10-item screening tool for the detection of depression and anxiety at primary healthcare clinics in Zambia in which the baseline detection rate among PWE was 1%. We trained primary care clinic workers in selected clinics to use this screening tool. A retrospective chart review was conducted for 120 consecutive PWE who received care one month after training. Detection improved from 1% to 49%, and treatment was frequently initiated. Of the 120 screened, 59 (49.2%) scored above cutoff point of 18. Of these persons, 43 (73.0%) were positive for depression, 16 (23.0%) were positive for anxiety, 38 (64.4%) received counseling, 18 (30.5%) received antidepressants, and 3 (5.1%) were referred to a psychiatrist. Use of this screening tool resulted in improved mental health care for PWE.

Authors & Co-authors:  Mbewe Edward K EK Uys Leana R LR Birbeck Gretchen L GL

Study Outcome 

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Statistics
Citations :  Rai D, Kerr MP, McManus S, Jordanova V, Lewis G, Brugha TS. Epilepsy and psychiatric comorbidity: a nationally representative population-based study. Epilepsia. 2012;53:1095–1103.
Authors :  3
Identifiers
Doi : 10.4269/ajtmh.13-0062
SSN : 1476-1645
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Study Design
Study Approach
Country of Study
Zambia
Publication Country
United States