Psychological Distress and Quality of Life Among Epilepsy Patients in Mazabuka District, Zambia

Abstract

Background: Epilepsy is accompanied by substantial psychosocial and mental health burdens that may affect quality of life, particularly in low-resource settings. This study assessed psychological distress, anxiety, depression, and quality of life among patients with epilepsy in Mazabuka District, Zambia, and explored experiences contributing to these outcomes. Methods: A parallel-convergent mixed-methods design combined quantitative surveys of 60 adult patients with qualitative interviews involving 30 participants and perspectives from 10 key informants. Psychological distress, anxiety, depression, and quality of life were assessed using the K10, GAD-7, PHQ-9, and QOLIE-31, respectively. Quantitative data were summarised descriptively and examined using prespecified inferential tests, while qualitative data were analysed thematically. Results: Mean K10, GAD-7, and PHQ-9 scores were 27.3, 10.4, and 14, respectively. Moderately severe depression was reported by 30.0% of patients, severe anxiety by 16.7%, and moderate quality of life by 53.3%. Seizure frequency was significantly associated with psychological distress, while longer epilepsy duration was associated with higher depression scores and unemployment with lower quality of life. Qualitative findings identified seizure unpredictability, stigma, financial strain, and reduced independence as important sources of distress, alongside coping through peer support, family involvement, mindfulness, and counselling. Conclusion: Psychological distress, anxiety, and depression were common, while quality of life remained moderate for many participants. The findings support integrated epilepsy care that includes routine mental health screening and psychosocial   support.