Abstract / Summary
Abstract Background and purpose Epilepsy is a chronic neurological condition that is frequently associated with psychiatric and nutritional comorbidities, which can adversely affect clinical outcomes and quality of life. Whilst studies have shown that the risk of malnutrition is common in patients with epilepsy and that psychiatric comorbidities are also increased, this study aimed to assess the risk of malnutrition in adults with epilepsy and its association with the burden of depression and anxiety. Methods This single-centre, cross-sectional analytical study included 360 patients with epilepsy who presented to the Adult Neurology Outpatient Clinic Faculty of Medicine between 1 August 2024 and 31 December 2024. The NRS-2002 was administered to all patients, with the MNA administered additionally to patients aged 65 and over. Depression was assessed using the Hamilton Depression Rating Scale, whilst anxiety was assessed using the Hamilton Anxiety Rating Scale. The Mann-Whitney U, Kruskal-Wallis, chi-square/Fisher’s exact and Spearman’s rho tests were used in the statistical analyses. Independent factors associated with the risk of malnutrition were assessed using multivariate binary logistic regression analysis. A two-tailed p-value of < 0.05 was considered statistically significant. Results The mean age of the patients was 34.63 ± 13.36 years, and 50.6 per cent of the cases were male. The mean NRS-2002 score was 0.74 ± 1.44 and the risk of malnutrition was found to be 16.9 per cent. According to the MNA results for the 15 patients aged 65 and over, 2 were malnourished and 1 was at risk of malnutrition. The mean HDRS score was 6.23 ± 7.57, and the mean HARS score was 5.83 ± 7.27. A significantly higher burden of depression and anxiety was observed in patients at risk of malnutrition (p < 0.001 for both). The number of seizures in the past year, the number of seizures requiring hospitalisation, the total number of seizures and the number of status epilepticus episodes showed a positive correlation with NRS-2002, HDRS and HARS scores. Whilst HDRS and HARS scores increased with age, no significant association was found with the NRS-2002. In multivariate logistic regression analyses, both depression severity (OR = 2.053; 95% CI: 1.442–2.924; p < 0.001) and anxiety severity (OR = 2.331; 95% CI: 1.582–3.435; p < 0.001) were found to be independently associated with the risk of malnutrition. Conclusion The risk of malnutrition in adult patients diagnosed with epilepsy is closely linked to the burden of depression and anxiety. A multidisciplinary approach to the management of epilepsy should be adopted, focusing not only on seizure control but also on nutritional status and psychiatric comorbidities.