title: Risk factors for depression in community-treated epilepsy: systematic review.
abstract: OBJECTIVE
  Depression is one of the most common psychiatric comorbidities in epilepsy; however, the factors contributing to this association remain unclear. There is a growing consensus that methodological limitations, particularly selection bias, affect many of the original studies. A systematic review focussed on community-based studies offers an alternative approach for the identification of the risk factors for depression.
  
  
  METHODS
  Searches were performed in MEDLINE (Ovid), 2000 to 31 December 2013, EMBASE, and Google Scholar to identify studies examining risk factors for depression in epilepsy. Community-based studies of adults with epilepsy that reported at least one risk factor for depression were included.
  
  
  RESULTS
  The search identified 17 studies that met selection criteria, representing a combined total of 12,212 people with epilepsy with a mean sample size of 718. The most consistent risk factors for depression were sociodemographic factors, despite the fact that most studies focus on epilepsy-related factors.
  
  
  CONCLUSIONS
  Most studies lacked a systematic conceptual approach to investigating depression, and few risk factors were consistently well studied. Future community-based studies require a detailed systematic approach to improve the ability to detect risk factors for depression in epilepsy. Psychological factors were rarely studied in community-based samples with epilepsy, although the consistent association with depression in the few studies that did suggests this warrants further examination.
authors.affiliation: Department of Psychiatry, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia; Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia. Electronic address: cameron.lacey@otago.ac.nz.
authors.forename: Cameron J
authors.initials: CJ
authors.lastname: Lacey
authors.affiliation: Department of Psychiatry, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia. Electronic address: msalzber@bigpond.net.au.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Salzberg
authors.affiliation: Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia. Electronic address: wendyl@unimelb.edu.au.
authors.forename: Wendyl J
authors.initials: WJ
authors.lastname: D'Souza
mesh_terms: D000328:Adult; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000209:etiology*; D004827:Epilepsy / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors
keywords: Comorbidity; Epidemiology; Seizure