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Description of Depression in People with Epilepsy in Aceh

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Description of Depression in People with Epilepsy in Aceh ORIGINAL ARTICLE Bali Medical Journal (Bali MedJ) 2021, Volume 10, Number 2: 521-525 P-ISSN.2089-1180, E-ISSN: 2302-2914 Description of depression in people with epilepsy in Aceh Published by Bali Medical Journal Nova Dian Lestari1,2*, Nirwana Lazuardi Sary3, Arina Khairu Ummah4, Zulkarnain3, Nur Astini1,2 1Department of Neurology, Faculty of Medicine, Universitas Syiah Kuala, Banda ABSTRACT Aceh, Indonesia; 2Department of Neurology, Dr Zainoel Background: Depression is the most common comorbid in people with epilepsy (PWE). Detection of depression in PWE is not Abidin Hospital, Banda Aceh, Indonesia; a routine examination at a neurology clinic because it takes a long time. The education of Acehnese people regarding epilepsy 3 Department of Physiology, Faculty of is still limited, leading to discrimination and stigma in society. It is not easy to carry out examinations, and the diagnosis is Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia; often overlooked. The objective of this study was to screen and to describe the characteristics of depression in PWE in Aceh. 4Undergraduate Medical Doctor Program, Method: This study was a descriptive observational study with the total respondents involved 41 PWEs. Detection of Faculty of Medicine, Universitas Syiah depression in PWE was conducted using the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), a valid, Kuala, Banda Aceh, Indonesia. reliable, shorter and more straightforward instrument test. The sample was determinate using the probability sampling method with a simple random sampling technique. *Corresponding author: Results: Our results found that 39% of respondents experienced depression, with the most NDDI-E scores ranged between Nova Dian Lestari; 11-15, with a percentage of 41.5%. Out of total, 57.1% of the depression occurred in women and those who aged between Department of Neurology, Faculty of 18-25 years old were more frequent to experience depression. Depression was more frequent among those who had no Medicine, Universitas Syiah Kuala, formal education (66.7%). Banda Aceh, Indonesia; Department of Conclusion: Depression in PWE in Aceh tends to occur in women, those with no education and those who worked as labor Neurology, Dr Zainoel Abidin Hospital, or farmer. Banda Aceh, Indonesia; [email protected] Keywords: Aceh, depression, epilepsy, NDDI-E, people with epilepsy. Received: 2021-04-17 Cite This Article: Lestari, N.D., Sary, N.L., Ummah, A.K., Zulkarnain., Astini, N. 2021. Description of depression in people with Accepted: 2021-06-19 epilepsy in Aceh. Bali Medical Journal 10(2): 521-525. DOI: 10.15562/bmj.v10i2.2389 Published: 2021-06-26 INTRODUCTION factors cause it, the stigma factor and the that often occurs in epileptic patients.11 natural factor of the brain. Self-stigma From a psychological perspective, the Epilepsy is a brain disorder characterized arises from the distrust of having to suffer terms depression and anxiety in epilepsy by a tendency to induce epileptic from epilepsy from the sufferer himself. are expressed as an increased emotional seizures with neurobiological, cognitive, Social stigma by society against PWE also response to seizures’ unpredictable psychological, and social consequences. frequently occurs in several countries, such nature and activity restriction.11 In the Epilepsy accounts for a significant as discrimination, humiliation, fear, and context of the two-way relationship proportion of 0.5% of the world’s disease interaction barriers.7 Another contributing between epilepsy and depression, not burden. As many as 80% of people with factor is a natural brain factor related to only is PWE at greater risk of developing epilepsy (PWE) live in low- and middle- 1–5 the imbalance of brain chemicals in PWE, depressive comorbidities, but patients income countries. Based on data which influences depression, such as low with depression had a four to seven times from the Central Statistics Agency of serotonin levels in the brain.8 Several higher risk of developing epilepsy.12–14 Aceh Province in 2016, epilepsy ranked PET studies have found that serotonin Depressive disorder ranked first in three third in mental health cases in Aceh receptors’ binding is reduced in various decades from 1990 to 2017. Several studies after schizophrenia and acute psychotic 5 PWE brain areas. The site with reduced explain that cases of depression in PWE disorders. serotonin receptor binding potential worldwide are recorded relatively high Epilepsy can occur at any age, gender, is ipsilateral with a resurgent focus, at 9.5-85 percent,15 and according to the and race and causes mortality and early 6 particularly during seizure onset and areas Institute of Health Metrics and Evaluation death. The risk of premature death in of seizure propagation. These factors have (IHME), depression is a factor that people with epilepsy can occur up to three a serious impact on PWE, which causes contributes to a large number of suicides times higher than the general population, sufferers to experience decreased quality in Indonesia.16 The results of primary with the highest early death rates in low- of life, depression, a worse prognosis, and health research (Riskesdas) 2018 by the and middle-income countries and rural 9,10 3 multiple suicidal impulses. Indonesian Ministry of Health showed areas. Proper treatment and diagnosis Depression is a comorbid symptom the prevalence of depression in the total can prevent these mortality rates. Two PublishedOpen access: by Baliwww.balimedicaljournal.org Medical Journal | Bali Medical Journal 2021; 10(2): 521-525 | doi: 10.15562/bmj.v10i2.2389 521 ORIGINAL ARTICLE population age more than 15 years old Table 1. Characteristics of respondent, NDDI-E score and depression in Indonesia reached 6.1%. Depressive Percentage Variables Frequency (n=41) disorders have started to occur since the (%) age range of adolescents (15-24 years), Gender with a prevalence of 6.2%.17 The prevalence Male 20 48.8 pattern of depression increases with Female 21 51.2 age. WHO data in 2019 from hundreds Age group (year) of millions of people in Indonesia, one 18-25 14 34.1 18 person dies due to suicide every hour. 26-35 12 29.3 During this time, the detection of 36-45 10 24.4 depression in PWE is not a routine 46-55 4 9.8 examination at the neurology clinic 56-65 1 2.4 because the assessment of depression takes Education a long time and it is difficult to do in the No School 3 7.3 outpatient clinic making this test is often Elementary 4 9.8 not performed. In addition, the diagnosis is Junior high school 8 19.5 19 often missed. Education of the Acehnese Senior high school 10 24.4 people regarding epilepsy is still limited College 16 39.0 due to emergence of discrimination and Profession negative stigma in the community, making Not Working 20 48.8 it more challenging to examine. Until Labor/Farmer 5 12.2 now, research on the characteristics of Entrepreneurial 6 14.6 PWE in Aceh has never been carried out. Private Employees 3 7.3 Therefore, this study sought to explore this Civil Servants/Military 6 14.6 problem by determine the incidence and Retired 1 2.4 the characteristics of depression in PWE NDDI-E Score using a valid, reliable, shorter Simpler 6-10 8 19.5 Neurological Disorders Depression 11-15 17 41.5 Inventory for Epilepsy (NDDI-E) 16-20 14 34.1 instrument. NDDI-E instrument is 21-25 2 4.9 reliable for detecting major depressive Depressive Events disorders in epileptic patients. The results for detection of depression have increased Depression 16 39.0 almost tenfold using this instrument.20 No Depression 25 61.0 NB: Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) METHODS This research is a descriptive observational with NDDI-E. The independentRESULTS study with a cross-sectional design. variables collected in this study included The data used are primary in the form demographic data and basic characteristics The distribution of characteristics of PWE of answers to an online questionnaire of epilepsy patients, including age, sex, in Aceh are presented in Table 1. Out of consisting of assessing depressive education level, and type of work. Then the total patients, 51.4% were women and symptoms in people with epilepsy using NDDI-E score was measured to determine most of the patients aged between 18-25 the Neurological Disorders Depression the condition of the depressive symptoms years old with a percentage of 34.1%. The Inventory for Epilepsy (NDDI-E). This experienced by epilepsy patients. The distribution of the social characteristics study’s sample consisted of 41 respondents NDDI-E score ranges from 6 to 25 divided of PWE can be assessed from the level of from Aceh province, consisting of people into 4 groups. The NDDI-E score > 15 is education and employment. The results with epilepsy who were over 18 years of categorized as a symptom of depression, showed that education for people with age and who did not experience severe while the score below is categorized epilepsy in Aceh was mainly at the college mental disorders obtained by probability as not experiencing depression. The level, with 39%. Based on employment, sampling method. Determining the data obtained were analyzed using the 48.8% of samples were not working (Table sample using a simple random sampling univariate test to explain and describe 1). From the research results on PWE in technique is carried out randomly without each research variable’s characteristics and Aceh, 46.3% did not have a regular income paying attention to the strata that exist in its relation with depression in epilepsy every month and did not have dependents the population members. patients in Aceh. that tended to dominate with a percentage The dependent variable of this study of 61%. was depressive symptoms measured 522 Published by Bali Medical Journal | Bali Medical Journal 2021; 10(2): 521-525 | doi: 10.15562/bmj.v10i2.2389 ORIGINAL ARTICLE Table 2.
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