BMJ Open. 2025 Sep 18;15(9):e098286. doi: 10.1136/bmjopen-2024-098286.
ABSTRACT
OBJECTIVES: This study aimed to assess the prevalence of depression and anxiety and to identify factors associated with these conditions among caregivers of children and adolescents with epilepsy attending the paediatric neurology clinic at Muhimbili National Hospital (MNH) in Tanzania.
DESIGN: A hospital-based cross-sectional study.
SETTING: The paediatric neurology clinic of a national referral hospital in Dar es Salaam, Tanzania.
PARTICIPANTS: 427 caregivers of children with epilepsy (CWE) were consecutively enrolled. Eligibility criteria included being 18 years or older and having provided care for the child for at least 6 months. Caregivers unable to read and write in Swahili or previously diagnosed with a mental illness before assuming the caregiving role were excluded.
PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were the prevalence of depression (assessed with the Patient Health Questionnaire-9 (PHQ-9), cut-off ≥10), anxiety (assessed with the Generalised Anxiety Disorder-7 tool (GAD-7), cut-off ≥10), and their co-occurrence. Secondary outcomes were the factors associated with these conditions, analysed using logistic regression and reported as adjusted odds ratios (aORs).
RESULTS: Depression was observed in 74 (17.3%, 95% CI: 13.8 to 21.3) participants and anxiety was found in 74 caregivers (17.3%,95% CI: 14.1 to 20.8). 38 (9.0%, 95% CI: 6.3 to 11.7) participants had concurrent depression and anxiety. Factors associated with depression were having a child: less than 5 years old (adjusted OR (aOR)=6.56, p=0.012), epilepsy duration of more than 5 years (aOR=2.80, p=0.048), history of epilepsy-related injuries (aOR=2.64, p=0.015) and three or more admissions (aOR=2.56, p=0.046). Caregivers whose children had not started school or were in primary school had lower odds of depression compared with counterparts in secondary school (aOR=0.02, p=0.003) and (aOR=0.03, p=0.005), respectively. Caregivers’ anxiety was associated with having a child with: another comorbidity (aOR=1.93, p=0.020), a history of epilepsy-related injuries (aOR=2.37, p=0.030), three or more admissions (aOR=2.98, p=0.015) and caregiver age between 41 to 50 years (aOR=3.06, p=0.042).
CONCLUSION: Depression and anxiety are prevalent among caregivers of CWE. The findings indicate a need for the integration of mental health services within paediatric neurology clinics to support caregiver well-being.
PMID:40973383 | DOI:10.1136/bmjopen-2024-098286
