New Study on Depression in Epilepsy Patients
“Improving the Detection of Depression and/or Anxiety Psychiatric Comorbidities in People with Epilepsy in Primary Health Care Institutions in Zambia”, was the title of a thesis which earned Dr Edward Mbewe his PhD in Nursing.
About 50 million people suffer from epilepsy (PWE) worldwide and of those 60% have depression and anxiety and 80% live in low-income regions. Common psychiatric comorbidities are often unrecognised and undertreated.
In this study, Mbewe developed and validated a 10-item screening tool for the detection of depression and anxiety at primary healthcare clinics in Zambia.
Mbewe said, ‘The tool can be used in clinics and hospitals. It takes about two minutes for a nurse, clinical officer or doctor to fill in the screening tool and score. The easiest thing is that the tool can be filled in by any community health worker who has been trained to do so and the training takes less than half a day.’
Primary care clinic workers in selected clinics were trained to use the screening tool and a retrospective chart review was conducted among 120 consecutive PWE’s, who received care one month after training. It was found that detection improved from 1% to 49%, and treatment was frequently initiated.
The study was undertaken in three phases. The first phase dealt with establishing the prevalence of psychiatric comorbidities of depression and anxiety in epilepsy patients, while the second phase involved the development of a screening tool for the psychiatric comorbidities.
Phase three was the implementation of the screening tool to establish if there was an improvement of screening among primary care workers.
The improvement was seen in the detection of psychiatric comorbidities. ‘To complete the thesis, data was gathered from patients, patients’ files and literature,’ said Mbewe. ‘Ethical clearance was obtained from the Michigan State University, the University of Zambia and the University of KwaZulu-Natal. The phases culminated in publications in international peer-reviewed journals.’
Mbewe is the Principal Lecturer at Chainama College of Health Sciences in Zambia, which deals with continuing education in health and research. He also runs workshops in various areas engaging medical personnel at primary health care level and is actively involved in teaching health personnel at all levels i.e. medical doctors, clinical officers, nurses and environmental health technologists.
In his spare time, Mbewe engages with youth at his church and plays the keyboard. He also works with various schools to raise awareness about epilepsy.
His study was supervised by the late Professor Leana Uys and Professor Gretchen Lano Birbeck- Zakia Jeewa