Prevalence of depression and suicidal ideation in persons with epilepsy during the COVID-19 pandemic: A longitudinal study from India

Objectives COVID-19 pandemic has disrupted healthcare services for chronic disorders such as epilepsy. In this study, the impact of COVID-19 pandemic on persons with epilepsy (PWE) with regard to their seizure control, depression status, and medication adherence was assessed. Methods After ethical clearance, 449 PWE who had been previously evaluated for depression at All India Institute of Medical Sciences (AIIMS), New Delhi, India, were telephonically revaluated using Mini International Neuropsychiatric Interview and surveyed for source of medication and medication adherence over last 6 months. The prevalence and the association of depression, suicidality and seizures during pandemic with different PWE variables were determined. Results Out of 449 PWE, 70.6% responded. 19.9% were diagnosed positive for depression as per MINI while suicidal ideation was observed in 5.4%. Seventy six (23.9%) PWE reported seizures during pandemic. The incidence being greater in females, unemployed, previously uncontrolled epilepsy, polytherapy, altered use of medications and depressed PWE. Seizure during pandemic, increased seizure frequency, previous history of depression and altered use of medications were all significantly associated with depression during COVID-19 pandemic (2.6- 95%CI, 1.45–4.73;1.9- 95%CI, 1.01–3.57;8.8- 95%CI, 4.54–17.21;2.9- 95%CI, 1.19–7.24), and polytherapy (2.9- 95%CI, 0.92–9.04), seizures during pandemic (3.9- 95%CI, 1.45–10.53) and previous history of depression and suicidality, were related with suicidal ideation. Conclusion COVID-19 pandemic induced disruptions can be detrimental for PWE and restoring services to the precovid levels as well as putting appropriate continuity plans in place for care of PWE should be a priority.