Psychological impact of the COVID-19 pandemic for patients with epilepsy: A systematic review and meta-analysis

Abstract

OBJECTIVE\nTo investigate psychological comorbidities in patients with epilepsy during the coronavirus disease 2019 (COVID-19) pandemic.\n\n\nMETHOD\nA systematic review and meta-analysis approach was used to comprehensively search MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov databases for relevant studies. Studies that reported psychological stress in patients with epilepsy during the COVID-19 pandemic were included. Psychological comorbidities were defined as anxiety, depression, and sleep disturbance. Pooled proportions of psychological comorbidities with 95% confidence intervals (CIs) were assessed using a random-effects model. The quality of assessment for each study, heterogeneity between the studies, and publication bias were also evaluated.\n\n\nRESULTS\nA total of 28 studies with 7959 patients/caregivers were included in the meta-analysis. The pooled proportions of anxiety/worry, depression/bad mood, and sleep disturbance were 38.9% (95% CI: 31.3-46.7); I2\u202f=\u202f97%; p\u202f<\u202f0.01, 30.9% (95% CI: 23.3-38.9), I2\u202f=\u202f97%; p\u202f<\u202f0.01, and 36.5% (95% CI: 28.3-45.1), I2\u202f=\u202f97%, p\u202f<\u202f0.01, respectively.\n\n\nCONCLUSION\nAlthough the heterogeneity was high, our results showed a relatively high incidence of psychological comorbidities. Therefore, clinicians need to intervene early in the stress of patients with epilepsy to prevent worsening of stress, which can result in seizure worsening.