{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:09:25Z","timestamp":1792451365076,"version":"4.5.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Epileptologica"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study was conducted to determine the prevalence of epilepsy in Daofu County, Sichuan Province, China, and to identify factors associated with comorbid depression, anxiety, and impaired quality of life among people with epilepsy (PWE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this community-based, cross-sectional study, a door-to-door survey of epilepsy was performed among 37,390 permanent residents of Daofu County. The survey identified 164 confirmed cases of epilepsy. Of them, 127 participants (aged\u2009\u2265\u200916\u00a0years) who were able to complete self-reported questionnaires were enrolled for final analysis. Depression and anxiety symptoms were assessed using the Chinese versions of the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E) and the Generalized Anxiety Disorder-7 (GAD-7) scale, respectively. Health-related quality of life was evaluated with the Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Factors associated with depression and anxiety were examined using logistic regression analyses, while factors influencing QOLIE-31 scores were assessed by linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The estimated prevalence of epilepsy in Daofu County was 4.4\u2030 (95% CI: 3.7\u20135.1\u2030). Independent factors associated with the comorbid depression included a low monthly household income per capita (aOR\u2009=\u20094.41, 95% CI: 1.82\u201310.71;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) and active epilepsy (aOR\u2009=\u20094.87, 95% CI: 1.74\u201313.62;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003). Independent factors associated with the comorbid anxiety included a low monthly household income per capita (aOR\u2009=\u20095.03, 95% CI: 1.88\u201313.5;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) and active epilepsy (aOR\u2009=\u20094.84, 95% CI: 1.95\u201312.01;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001). Furthermore, factors including a low monthly household income per capita, a history of status epilepticus, and active epilepsy were significantly associated with a lower QOLIE-31 score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is a high burden of depression and anxiety among PWE in the Tibetan areas of China. Active epilepsy is the most potent, independent risk factor of psychiatric comorbidities and poorer quality of life. These findings suggest the urgent need for integrated epilepsy management and mental health services in this resource-limited region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s42494-026-00256-4","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T02:11:40Z","timestamp":1775527900000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical characteristics and factors associated with psychiatric comorbidity among people with epilepsy in Ganzi Tibetan autonomous prefecture of China: a cross-sectional study"],"prefix":"10.1186","volume":"8","author":[{"given":"Chunxia","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liusha","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangzhou","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"issue":"10172","key":"256_CR1","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1016\/S0140-6736(18)32596-0","volume":"393","author":"RD Thijs","year":"2019","unstructured":"Thijs RD, Surges R, O\u2019Brien TJ, Sander JW. Epilepsy in adults. Lancet. 2019;393(10172):689\u2013701.","journal-title":"Lancet"},{"issue":"5","key":"256_CR2","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1111\/j.1528-1167.2009.02481.x","volume":"51","author":"AK Ngugi","year":"2010","unstructured":"Ngugi AK, Bottomley C, Kleinschmidt I, Sander JW, Newton CR. Estimation of the burden of active and life-time epilepsy: a meta-analytic approach. Epilepsia. 2010;51(5):883\u201390.","journal-title":"Epilepsia"},{"issue":"1","key":"256_CR3","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-65768-6","volume":"10","author":"A Muhigwa","year":"2020","unstructured":"Muhigwa A, Preux PM, G\u00e9rard D, Marin B, Boumedi\u00e8ne F, Ntamwira C, et al. Comorbidities of epilepsy in low and middle-income countries: systematic review and meta-analysis. Sci Rep. 2020;10(1):9015.","journal-title":"Sci Rep"},{"issue":"3","key":"256_CR4","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.lpm.2017.10.019","volume":"47","author":"B de Toffol","year":"2018","unstructured":"de Toffol B, Hingray C, Biberon J, El-Hage W. Les comorbidit\u00e9s psychiatriques dans l\u2019\u00e9pilepsie [Psychiatric comorbidities in epilepsy]. Presse Med. 2018;47(3):243\u201350 (in French).","journal-title":"Presse Med"},{"issue":"5","key":"256_CR5","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1111\/j.0013-9580.2004.47003.x","volume":"45","author":"EK Johnson","year":"2004","unstructured":"Johnson EK, Jones JE, Seidenberg M, Hermann BP. The relative impact of anxiety, depression, and clinical seizure features on health-related quality of life in epilepsy. Epilepsia. 2004;45(5):544\u201350.","journal-title":"Epilepsia"},{"issue":"9","key":"256_CR6","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.1212\/01.WNL.0000059867.35547.DE","volume":"60","author":"WZ Wang","year":"2003","unstructured":"Wang WZ, Wu JZ, Wang DS, Dai XY, Yang B, Wang TP, et al. The prevalence and treatment gap in epilepsy in China: an ILAE\/IBE\/WHO study. Neurology. 2003;60(9):1544\u20135.","journal-title":"Neurology"},{"issue":"8","key":"256_CR7","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1016\/j.seizure.2014.05.002","volume":"23","author":"X Pi","year":"2014","unstructured":"Pi X, Zhou L, Cui L, Liu A, Zhang J, Ma Y, et al. Prevalence and clinical characteristics of active epilepsy in southern Han Chinese. Seizure. 2014;23(8):636\u201340.","journal-title":"Seizure"},{"issue":"3","key":"256_CR8","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.yebeh.2007.10.012","volume":"12","author":"Y Zhao","year":"2008","unstructured":"Zhao Y, Zhang Q, Tsering T, Sangwan Hu X, Liu L, Shang H, et al. Prevalence of convulsive epilepsy and health-related quality of life of the population with convulsive epilepsy in rural areas of Tibet Autonomous Region in China: an initial survey. Epilepsy Behav. 2008;12(3):373\u201381.","journal-title":"Epilepsy Behav"},{"issue":"Pt 3","key":"256_CR9","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1093\/brain\/115.3.783","volume":"115","author":"M Placencia","year":"1992","unstructured":"Placencia M, Sander JW, Shorvon SD, Ellison RH, Cascante SM. Validation of a screening questionnaire for the detection of epileptic seizures in epidemiological studies. Brain. 1992;115(Pt 3):783\u201394.","journal-title":"Brain"},{"issue":"4","key":"256_CR10","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1111\/epi.12550","volume":"55","author":"RS Fisher","year":"2014","unstructured":"Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. Ilae official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475\u201382.","journal-title":"Epilepsia"},{"issue":"10","key":"256_CR11","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1111\/epi.13121","volume":"56","author":"E Trinka","year":"2015","unstructured":"Trinka E, Cock H, Hesdorffer D, Rossetti AO, Scheffer IE, Shinnar S, et al. A definition and classification of status epilepticus- -report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015;56(10):1515\u201323.","journal-title":"Epilepsia"},{"issue":"6","key":"256_CR12","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1111\/j.1528-1167.2011.03041.x","volume":"52","author":"SD Shorvon","year":"2011","unstructured":"Shorvon SD. The etiologic classification of epilepsy. Epilepsia. 2011;52(6):1052\u20137.","journal-title":"Epilepsia"},{"key":"256_CR13","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.yebeh.2017.10.020","volume":"78","author":"X Ding","year":"2018","unstructured":"Ding X, Zheng Y, Guo Y, Shen C, Wang S, Chen F, et al. Active epilepsy prevalence, the treatment gap, and treatment gap risk profile in eastern China: a population-based study. Epilepsy Behav. 2018;78:20\u20134.","journal-title":"Epilepsy Behav"},{"issue":"1","key":"256_CR14","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1046\/j.1528-1157.2001.32800.x","volume":"42","author":"H Meinardi","year":"2001","unstructured":"Meinardi H, Scott RA, Reis R, Sander JW. The treatment gap in epilepsy: the current situation and ways forward. Epilepsia. 2001;42(1):136\u201349.","journal-title":"Epilepsia"},{"issue":"5","key":"256_CR15","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.seizure.2014.01.007","volume":"23","author":"J Hu","year":"2014","unstructured":"Hu J, Si Y, Zhou D, Mu J, Li J, Liu L, et al. Prevalence and treatment gap of active convulsive epilepsy: a large community-based survey in rural West China. Seizure. 2014;23(5):333\u20137.","journal-title":"Seizure"},{"key":"256_CR16","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.yebeh.2015.03.012","volume":"47","author":"X Tong","year":"2015","unstructured":"Tong X, An D, Lan L, Zhou X, Zhang Q, Xiao F, et al. Validation of the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E) in West China. Epilepsy Behav. 2015;47:6\u201310.","journal-title":"Epilepsy Behav"},{"issue":"Pt A","key":"256_CR17","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.yebeh.2016.02.015","volume":"57","author":"JA Micoulaud-Franchi","year":"2016","unstructured":"Micoulaud-Franchi JA, Lagarde S, Barkate G, Dufournet B, Besancon C, Tr\u00e9buchon-Da Fonseca A, et al. Rapid detection of generalized anxiety disorder and major depression in epilepsy: validation of the GAD-7 as a complementary tool to the NDDI-E in a French sample. Epilepsy Behav. 2016;57(Pt A):211\u20136.","journal-title":"Epilepsy Behav"},{"issue":"1","key":"256_CR18","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1111\/j.1528-1157.1998.tb01278.x","volume":"39","author":"JA Cramer","year":"1998","unstructured":"Cramer JA, Perrine K, Devinsky O, Bryant-Comstock L, Meador K, Hermann B. Development and cross-cultural translations of a 31-item quality of life in epilepsy inventory. Epilepsia. 1998;39(1):81\u20138.","journal-title":"Epilepsia"},{"key":"256_CR19","unstructured":"National Bureau of Statistics of the People's Republic of China. http:\/\/www.stats.gov.cn. Accessed 10 May 2025."},{"issue":"1-2","key":"256_CR20","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.eplepsyres.2013.02.002","volume":"105","author":"L Gu","year":"2013","unstructured":"Gu L, Liang B, Chen Q, Long J, Xie J, Wu G, et al. Prevalence of epilepsy in the People\u2019s Republic of China: a systematic review. Epilepsy Res. 2013;105(1\u20132):195\u2013205.","journal-title":"Epilepsy Res"},{"key":"256_CR21","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00891","volume":"9","author":"J Chen","year":"2018","unstructured":"Chen J, Wu X, He Y, Li S, Deng Y, Chen J, et al. A Retrospective Analysis of the Clinical Features of Inpatients With Epilepsy in the Ganzi Tibetan Autonomous Prefecture. Front Neurol. 2018;9:891.","journal-title":"Front Neurol"},{"key":"256_CR22","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2021.106643","volume":"174","author":"S Li","year":"2021","unstructured":"Li S, Chen J, He Y, Chen J, Liao S, Deng Y, et al. Incidence and risk factors associated with the development of epilepsy in patients with intracranial alveolar echinococcosis. Epilepsy Res. 2021;174:106643.","journal-title":"Epilepsy Res"},{"key":"256_CR23","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.seizure.2019.02.014","volume":"66","author":"Q Li","year":"2019","unstructured":"Li Q, Chen D, Zhu LN, Wang HJ, Xu D, Tan G, et al. Depression in people with epilepsy in West China: Status, risk factors and treatment gap. Seizure. 2019;66:86\u201392.","journal-title":"Seizure"},{"issue":"6","key":"256_CR24","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1111\/ane.13016","volume":"138","author":"HJ Wang","year":"2018","unstructured":"Wang HJ, Tan G, Deng Y, He J, He YJ, Zhou D, et al. Prevalence and risk factors of depression and anxiety among patients with convulsive epilepsy in rural West China. Acta Neurol Scand. 2018;138(6):541\u20137.","journal-title":"Acta Neurol Scand"},{"key":"256_CR25","doi-asserted-by":"publisher","DOI":"10.1177\/17562864231187194","volume":"16","author":"W Shi","year":"2023","unstructured":"Shi W, Sun H, Peng W, Chen Z, Wang Q, Lin W, et al. Prevalence and risk factors of anxiety and depression in adult patients with epilepsy: a multicenter survey-based study. Ther Adv Neurol Disord. 2023;16:17562864231187194.","journal-title":"Ther Adv Neurol Disord"},{"issue":"4","key":"256_CR26","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1002\/epi4.12958","volume":"9","author":"EB Hajji","year":"2024","unstructured":"Hajji EB, Traore B, Hassoune S, Khoubila A, Bellakhdar S, Rafai MA, et al. Prevalence and associated factors of psychiatric comorbidities in epilepsy in the Casablanca-Settat region of Morocco: a cross-sectional study. Epilepsia Open. 2024;9(4):1321\u201332.","journal-title":"Epilepsia Open"},{"key":"256_CR27","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2024.109648","volume":"152","author":"T Tinsae","year":"2024","unstructured":"Tinsae T, Shumet S, Melkam M, Segon T, Medfu Takelle G, Rtbey G, et al. Psychiatric comorbidity in people with epilepsy in Ethiopia: systematic review and meta-analysis. Epilepsy Behav. 2024;152:109648.","journal-title":"Epilepsy Behav"},{"key":"256_CR28","doi-asserted-by":"publisher","DOI":"10.1186\/s13033-017-0151-5","volume":"11","author":"R Tsigebrhan","year":"2017","unstructured":"Tsigebrhan R, Hanlon C, Medhin G, Fekadu A. Help seeking and suicidality among people with epilepsy in a rural low income country setting: cross-sectional survey. Int J Ment Health Syst. 2017;11:44.","journal-title":"Int J Ment Health Syst"},{"key":"256_CR29","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.1000870","volume":"13","author":"NI Malik","year":"2022","unstructured":"Malik NI, Fatima R, Ullah I, Atta M, Awan A, Nashwan AJ, et al. Perceived stigma, discrimination and psychological problems among patients with epilepsy. Front Psychiatry. 2022;13:1000870.","journal-title":"Front Psychiatry"},{"issue":"5","key":"256_CR30","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1111\/epi.13723","volume":"58","author":"CB Josephson","year":"2017","unstructured":"Josephson CB, Patten SB, Bulloch A, Williams JVA, Lavorato D, Fiest KM, et al. The impact of seizures on epilepsy outcomes: a national, community-based survey. Epilepsia. 2017;58(5):764\u201371.","journal-title":"Epilepsia"},{"key":"256_CR31","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2019.106669","volume":"102","author":"C Campbell","year":"2020","unstructured":"Campbell C, Cavalleri GL, Delanty N. Exploring the genetic overlap between psychiatric illness and epilepsy: a review. Epilepsy Behav. 2020;102:106669.","journal-title":"Epilepsy Behav"},{"issue":"1","key":"256_CR32","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/0006-8993(96)00203-X","volume":"725","author":"DG Fujikawa","year":"1996","unstructured":"Fujikawa DG. The temporal evolution of neuronal damage from pilocarpine-induced status epilepticus. Brain Res. 1996;725(1):11\u201322.","journal-title":"Brain Res"},{"key":"256_CR33","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.neuropharm.2014.01.035","volume":"81","author":"EM Prager","year":"2014","unstructured":"Prager EM, Aroniadou-Anderjaska V, Almeida-Suhett CP, Figueiredo TH, Apland JP, Rossetti F, et al. The recovery of acetylcholinesterase activity and the progression of neuropathological and pathophysiological alterations in the rat basolateral amygdala after soman-induced status epilepticus: relation to anxiety-like behavior. Neuropharmacology. 2014;81:64\u201374.","journal-title":"Neuropharmacology"},{"key":"256_CR34","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2022.105633","volume":"165","author":"T Singh","year":"2022","unstructured":"Singh T, Batabyal T, Kapur J. Neuronal circuits sustaining neocortical-injury-induced status epilepticus. Neurobiol Dis. 2022;165:105633.","journal-title":"Neurobiol Dis"}],"container-title":["Acta Epileptologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42494-026-00256-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42494-026-00256-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42494-026-00256-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T02:11:43Z","timestamp":1775527903000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s42494-026-00256-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["256"],"URL":"https:\/\/doi.org\/10.1186\/s42494-026-00256-4","relation":{},"ISSN":["2096-9384","2524-4434"],"issn-type":[{"value":"2096-9384","type":"print"},{"value":"2524-4434","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"assertion":[{"value":"24 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki. Ethical approval was granted by the Biomedical Ethics Review Committee West China Hospital, Sichuan University (Approval No.\u00a02025\u20132092). Written informed consent was obtained from all individual participants included in the study (or from parents\/legal guardians of participants under 16).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All participants (or their parents\/legal guardians for those under 16) had provided written informed consent for the publication of their anonymized data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16"}}