PSYCHIATRIC COMORBIDITIES AND THEIR IMPACT ON ANTIEPILEPTIC DRUG ADHERENCE AND CLINICAL OUTCOMES IN PERSONS WITH EPILEPSY: A CROSS-SECTIONAL STUDY

Objectives: The objective of the study was to determine the prevalence of psychiatric comorbidities among persons with epilepsy and to examine
their relationship with antiepileptic drug (AED) adherence and seizure-related clinical outcomes.
Methods: A hospital-based cross-sectional study was conducted in the outpatient department of St. Isabel Hospital, Chennai, Tamil Nadu, India, over
1 year. Adults aged 18–60 years with epilepsy (International League against Epilepsy criteria) were consecutively recruited (n=103). Psychiatric
diagnoses were assessed using the Mini International Neuropsychiatric Interview. Clinical variables included seizure type, seizure frequency, duration
of epilepsy, AED regimen, duration of AED use, and AED adherence categorized as good, fair, or poor. Descriptive statistics were generated, and
bivariate associations were explored.
Results: Overall, 45/103 participants (43.7%) had at least one psychiatric comorbidity. Depressive disorders were most frequent (19.4%), followed by
psychotic disorders (9.7%) and generalized anxiety disorder (8.7%); overlapping diagnoses were observed. Most participants were on monotherapy
(83.5%), and 18/103 (17.5%) reported poor AED adherence. Higher annual seizure frequency (>10 episodes/year) was documented in 27/103
participants (26.2%. Psychiatric comorbidity clustered with partial seizures, higher seizure frequency, longer epilepsy duration, and poorer AED
adherence in bivariate analyses.
Conclusion: Psychiatric comorbidities were common in this epilepsy cohort and were associated with poorer AED adherence and higher seizure
frequency. Routine mental health screening and integrated management may help identify patients at risk of poorer epilepsy-related outcomes.