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Depressive symptoms affect 40% and anxiety 36% of adults with epilepsyDepression and anxiety common in epilepsy

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Key Takeaway
Screen adults with epilepsy for depression and anxiety; both affect over a third of patients.

This meta-analysis pooled data from cross-sectional studies to estimate the occurrence of depressive and anxiety symptoms in adults with epilepsy. The analysis included 12 studies for depression (n=3866) and 14 studies for anxiety (n=4321). The pooled proportion of depressive symptoms was 40% (95% CI: 30-50%), with 1358 screen-positive out of 3866. For anxiety symptoms, the pooled proportion was 36% (95% CI: 28-44%), with 1515 screen-positive out of 4321. Heterogeneity was very high for both outcomes (I²=97.54% for depression, I²=96.64% for anxiety).

The authors note that depressive and anxiety symptoms are frequent in people with epilepsy, supporting systematic screening and integrated mental health care within epilepsy management. However, the analysis is based on observational studies, so the results represent associations, not causation. The meta-analysis did not report on adverse events, follow-up duration, or specific limitations. The high heterogeneity suggests that the pooled estimates should be interpreted with caution, as the true prevalence may vary across populations and settings.

For clinicians, these findings underscore the importance of screening for depression and anxiety in adults with epilepsy, as these conditions are common and may be underrecognized. Integrating mental health care into epilepsy management could help address this burden, but the observational nature of the data means that causality cannot be inferred.

How this fits prior evidence

This meta-analysis extends prior coverage by quantifying the high burden of depressive and anxiety symptoms in adults with epilepsy, complementing earlier findings that rTMS improves depression and that exercise may reduce symptoms in other populations. It also aligns with the observation that dissociative symptoms correlate with poorer outcomes, suggesting that mental health comorbidities are common across conditions. The high prevalence estimates reinforce the need for screening, as seen in other at-risk groups like older adults with sensory impairment.

A new meta-analysis pooling data from multiple studies finds that depressive and anxiety symptoms are common in adults with epilepsy. The analysis included 12 cross-sectional studies for depression, with 3,866 participants, and 14 studies for anxiety, with 4,321 participants. Overall, about 40% of people with epilepsy screened positive for depressive symptoms, and about 36% screened positive for anxiety symptoms. These numbers are higher than what is typically seen in the general population, suggesting that mental health issues are a significant concern for people living with epilepsy.

The study is a meta-analysis of observational data, which means it can show a link but cannot prove that epilepsy causes depression or anxiety. The results are based on screening tools, not formal diagnoses, and the studies varied widely in their findings, as indicated by high statistical heterogeneity. The analysis did not report on safety or side effects, as it was not a treatment study.

The main takeaway is that mental health symptoms are frequent in people with epilepsy, and the authors suggest that systematic screening and integrated mental health care should be part of epilepsy management. If you or someone you know has epilepsy and is experiencing symptoms of depression or anxiety, it is important to talk to a healthcare provider about screening and support options.

What this means for you:
Depression and anxiety are common in adults with epilepsy, so screening and mental health support are important.

Common questions

How common are depression and anxiety in people with epilepsy?

In this meta-analysis, about 40% of adults with epilepsy screened positive for depressive symptoms, and about 36% screened positive for anxiety symptoms. These numbers come from pooling data from multiple studies, but the actual rates can vary widely between different groups.

Does epilepsy cause depression or anxiety?

This study shows a link, but it cannot prove that epilepsy causes depression or anxiety. The analysis is based on observational studies, which can only show associations. Many factors, including the challenges of living with epilepsy, may contribute to mental health symptoms.

What should I do if I have epilepsy and feel depressed or anxious?

If you have epilepsy and are experiencing symptoms of depression or anxiety, it is important to talk to your doctor. They can screen you for these conditions and discuss treatment options. This study supports the idea that mental health screening should be a regular part of epilepsy care.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedAug 2026
View Original Abstract ↓
BACKGROUND: People with epilepsy (PWE) are at increased risk of psychiatric comorbidities, particularly depression and anxiety. These conditions adversely affect adherence, quality of life, and seizure control, yet reported frequencies and correlates vary widely. We aimed to estimate the occurrence of depressive and anxiety symptoms in PWE and summarize associated demographic and clinical variables. METHODS: We searched five databases for studies published between 2018 and 2024. Observational studies assessing symptoms or diagnoses of depression and/or anxiety in adults with epilepsy using validated instruments were included. Study selection, data extraction, and quality appraisal (JBI) were performed independently by multiple reviewers. Random-effects meta-analyses (REML) were conducted using cross-sectional, screening-based proportions. RESULTS: Fifty-four studies were included for data extraction; 49 reported depression outcomes and 33 anxiety outcomes (some reported both). Meta-analysis included 12 cross-sectional studies of depressive symptoms (n = 3866; 1358 screen-positive) and 14 cross-sectional studies of anxiety symptoms (n = 4321; 1515 screen-positive). The pooled proportion was 40% for depression (95% CI: 30-50%; I = 97.54%; Q = 427.70, p < 0.001) and 36% for anxiety (95% CI: 28-44%; I = 96.64%; Q = 250.60, p < 0.001). Both outcomes were frequently associated with female sex, polytherapy, temporal lobe epilepsy, and higher seizure frequency; drug-resistant epilepsy and poor seizure control were also commonly reported. CONCLUSION: Depressive and anxiety symptoms are frequent in PWE, supporting systematic screening and integrated mental health care within epilepsy management.
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