Perceptions about mental healthcare for people with epilepsy in Africa

Abstract

Background: Mental illness is commonly comorbid with epilepsy. In sub-Saharan Africa there exists limited access to neurological and psychiatric services predisposing to a ''treatment gap" in epilepsy and mental healthcare. Aims: To understand healthcare providers' knowledge, attitudes, and management practices toward epilepsy and comorbid mental illness in sub-Saharan Africa. Methods: A cross-sectional online survey following the STROBE guidance was conducted among healthcare providers in sub-Saharan Africa. Eleven questions looking to ascertain clinician demographics, knowledge of epilepsy, and comorbid mental illness as well as management practices were developed. Findings: Of 203 responses most (92%) respondents recognized a bi-directional relationship between mental health and epilepsy. However, mental illness screening in people newly diagnosed with epilepsy was infrequently performed (14%). Only 1 in 7 (16%) respondents had high confidence in their clinical competence at managing psychiatric comorbidities. Most would value further training (74%) and improvements to be made in current management practices within their local healthcare settings (94%). Conclusions: This pilot study highlights the need to improve the awareness of management of mental disorders in populations with epilepsy within sub-Saharan Africa in health providers there.

Impact of a free medication intervention on seizure recurrence and anxious and depressive symptoms in people living with epilepsy in the Republic of Guinea

“…The average seizure frequency over the 30 days prior to follow up was 1.5 (95%CI [0.5, 2.6]) and significantly lower than at baseline (p = 0.002). 66% of participants were No to mild depressive symptoms (0-9 points), moderate (10)(11)(12)(13)(14)(15)(16)(17)(18)(19), severe (20)(21)(22)(23)(24)(25)(26)(27) No to mild anxious symptoms (0-4 points), moderate (5)(6)(7)(8)(9)(10)(11)(12)(13)(14), severe (15)(16)(17)(18)(19)(20)(21) F I G U R E 2 Distribution of scores on the PHQ-9 (a) and GAD-7 (b) at baseline and 90-day follow up.…”

“…Left untreated or undertreated, epilepsy is highly linked to mental health disorders as well as unintentional injury, sudden death, and high self-perception of stigma [1,[10][11][12]. In Guinea, 25% of PLWE who sought ASM treatment endorsed thoughts of suicide or self-harm in our prior work [9], a high proportion in what is largely considered a treatable brain disorder and a concerning statistic given epilepsy healthcare providers in Sub-Saharan Africa screen for mental health disorders infrequently (14% of newly diagnosed PLWE) and only 16% report high levels of confidence in competently managing psychiatric comorbidities [13].…”

Epilepsy Knowledge, Attitudes and Practices of Front-Line Healthcare Workers in the City of Conakry

“…Management must be based on a variety of approaches, taking into account patients from different cultural and family backgrounds, different ages or regions and different environments [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54]. Some studies have focused on the treatment, etiologies and burden of disease of countries in the tropics, aiming to formulate appropriate policies for epileptics [55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71].…”

Status of epilepsy in the tropics: An overlooked perspective

“…Currently, there are several studies on PWE. Researchers have taken different approaches, such as focusing on patients with different cultural and family backgrounds, [5][6][7] different ages, [8][9][10][11][12][13] region-specific, [14][15][16][17][18][19][20][21][22] and inter-environmental. [23][24][25] Some studies have focused on the treatment gap, [26][27][28][29][30] special etiology, [31][32][33][34][35][36] and disease burden [37][38][39][40] in the tropics, aiming to formulate appropriate policies [41][42][43][44] for PWE.…”