افسردگی در افراد مبتلا به صرع: همکاران آسیایی آن را تا چه اندازه تایید می کنند؟ Depression in people with epilepsy: How much do Asian colleagues acknowledge it?

1. Introduction Depression has been observed to be highly prevalent in people with epilepsy (PWE). A systematic review and meta-analysis of its prevalence, revealed a 23.1% (95% confidence interval [CI] 20.6%– 28.31%) [1] prevalence of active depression which is much higher than that in the general population. In a population-based study [2], the average lifetime and 12-month prevalence estimates of major depressive episodes were 14.6% and 5.5%, respectively in the 10 highest-income countries, and 11.1% and 5.9% in the eight countries with low- to middle-income. However, depression is often under-recognized and improperly treated in PWE, which is associated with work absenteeism, increased utilization of health care services and direct medical costs [3,4]. Asia is the most populated continent in the world and is very diverse with respect to culture, ethnicity, religion, and other socio-demographic characteristics of the residents compared with the people in other continents. Studies about epilepsy and its comorbidities, including depression, are lacking from many Asian countries. The purpose of this review was to investigate the prevalence of depression in PWE in different countries in Asia. We also investigated how depression and depressive symptoms were evaluated in different studies in distinct Asian countries. 2. Methods We searched the electronic database PubMed on June 13, 2017 for articles in English that included the following search terms: “epilepsy” AND “depression” AND “country name” for all Asian countries since 1947. If the initial search resulted in a high number of papers (>40 papers), we limited the search to the title and abstract for all countries and searches. Relevant original studies from Asia were included if they reported the prevalence of depression in PWE. Papers studying special populations (e.g., elderly, veterans, etc.) were not included. In addition, experts in epilepsy field were invited from some Asian countries (Japan, China, Korea, Thailand, Taiwan, and Iran). Each expert was asked to review the prevalence of depression in their country based on the previously published literature for an in-depth assessment.