Anxiety and depression in people with epilepsy during and one year after the COVID-19 pandemic.

Objective: Compare the prevalence and severity of anxiety and depression among people with epilepsy (PWE) evaluated by telemedicine during the initial stages of the COVID-19 pandemic and follow up on their status 15 months later.

Methods: We conducted a prospective, observational, and analytical study at the Epilepsy Clinic of the National Institute of Neurology and Neurosurgery (NINN) in Mexico City during the COVID-19 pandemic. HADS-A and HADS-D instruments were administered to adult patients diagnosed with epilepsy, initially through telemedicine and later through in-person visits or phone calls after one year.

Results: A sample of 115 patients was obtained, with 62.5% being women. The mean age of the patients was 33.6 years (± 12), and the mean age of epilepsy onset was 16.82 years (± 13.82). The majority of patients had focal epilepsy (78.3%), and only 42% reported being seizure-free. The results from the HADS-A scale showed that 48.69% of the patients had anxiety. On the HADS-D scale, 29.56% of the patients were found to have depression. At follow-up, the HADS-A results indicated that 50.64% of the patients had anxiety, and the HADS-D results showed that 36.36% had depression. An analysis of associations between sociodemographic or clinical variables and the presence of anxiety and/or depression in PWE revealed no statistically significant results, except for the clinical variable of patients taking anxiolytic or antidepressant medications during the assessment. These patients had lower HADS-A and HADS-D scores, with a statistically significant p-value of 0.0001.

Significance: Comparing these findings with a previously published paper by our group showed a significant increase in both depression and anxiety, which were already prevalent in the earlier study. In conclusion, PWE exhibited high levels of anxiety and depression during and one year after the pandemic, despite receiving appropriate treatment. These symptoms, present before the pandemic, have been further exacerbated and continue to persist.

Plain language summary: This study examined anxiety and depression in patients with epilepsy (PWE) during the COVID-19 pandemic at the National Institute of Neurology and Neurosurgery in Mexico. Using the HADS-A and HADS-D scales, 115 patients were assessed over a year. Results showed that 48.69% had anxiety and 29.56% had depression, with both increasing to 50.64% and 36.36%, respectively, after one year. The only significant finding was that patients on anxiolytic or antidepressant medication had lower scores for anxiety and depression. The study concludes that anxiety and depression in PWE worsened during the pandemic and persisted despite treatment.