Depression and anxiety are associated with reduced antiepileptic drug adherence in Chinese patients

- Over one-third (39.7%) of our patients had low adherence to antiepileptic drugs.
- Depression scores had a significant negative correlation with adherence.
- Anxiety scores had a significant negative correlation with adherence.
- Targeting depression and anxiety can help identify patients at risk of nonadherence.

ObjectiveThe aim of this study was to investigate the association of depression and anxiety with adherence to antiepileptic drugs (AEDs) in Chinese patients with epilepsy.MethodsA total of 184 Chinese patients with epilepsy, and without cognitive impairment, underwent psychometric tests: the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). Adherence to antiepileptic drugs was measured by the eight-item Morisky Medication Adherence Scale (MMAS-8). Data on patients' demographic characteristics, disease characteristics, and treatment characteristics were also collected.ResultsThe MMAS-8 indicated that 39.7% of the patients had low adherence, 34.2% had moderate adherence, and 26.1% had high adherence. Demographic, disease, and treatment characteristics were not significantly different between the low adherence group and the moderate-to-high adherence group. Thirty-six (19.6%) patients had moderate-to-severe depression according to the BDI, and 47 (25.5%) patients were considered anxious according to the BAI. A significant difference in depression scores was found between the low adherence group and the moderate-to-high adherence group (χ2 = 13.625, P < 0.001). We also found a significant difference in anxiety scores between the two groups (χ2 = 8.331, P = 0.004). Pearson's correlations indicated that depression scores (r = − 0.281, P < 0.001) and anxiety scores (r = − 0.255, P < 0.001) were negatively correlated with adherence. Negative correlations were found between BDI scores and items 2, 7, and 8 of the MMAS-8 (P < 0.05); negative correlations were also found between BAI scores and items 3 and 6-8 (P < 0.05).ConclusionDepression and anxiety were associated with reduced antiepileptic drug adherence in Chinese patients. Addressing depression and anxiety among patients with epilepsy may help improve adherence to AEDs.