Depression and comorbidity in community-based patients with epilepsy or asthma

Objectives: To assess the frequency of depression symptoms, quality of life, and disability in a community-based sample of epilepsy (EPI), asthma, and healthy control (NCH) subjects, and the relationship of depression with EPI-specific aspects of quality of life, social concerns, antiepileptic drug-related side effects, and employment. Methods: Mail survey with depression (Center for Epidemiology Studies-Depression Scale [CES-D]), quality of life (Short Form [SF]-36), and Sheehan Disability (SDS) scales to 775 EPI, 395 asthma, and 362 NCH subjects. EPI subjects completed Quality of Life in Epilepsy-89 (QOLIE-89), Social Concerns Index, Adverse Events Profile, and employment questions. Results: A total of 36.5% EPI, 27.8% asthma, and 11.8% NCH were positive on CES-D (p < 0.001). EPI had the most prior consultations and treatments for depression but 38.5% of EPI-CES-D+ and 43.7% of asthma-CES-D+ were never previously evaluated for depression. EPI subjects had worse quality of life on SF-36 subscales and greater SDS disability but were similarly disabled as asthma subjects in the presence of depression. Among EPI subjects, CES-D-based depression was significantly associated with being female, being younger, lower income, worse QOLIE-89 scores, more SDS disability, more social concerns, more adverse drug events, less past-month employment, and fewer working days. Conclusions: Depression is common in community-based epilepsy and asthma patients, and is associated with diverse impairments.