{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T11:18:15Z","timestamp":1781781495060,"version":"3.54.5"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:00:00Z","timestamp":1670544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100022150","name":"Debre Tabor University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022150","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Epilepsy is the most common neurologic disorder which is further complicated by neurobehavioral co-morbidities, cognitive impairment, psychiatric disorders, and social problems. However, assessments of cognitive status of epileptic patients are far too low during clinical visits. This calls for early neuropsychological assessment soon after the diagnosis of epilepsy for a better treatment plan and outcome for epileptic patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>This study aimed to assess the cognitive adverse effects of epilepsy and its predictors attending outpatient departments of South Gondar Zone hospitals Amhara region Ethiopia 2020\/2021.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A multi-center institutional-based cross-sectional study was conducted. A total of 509 respondents were included with a response rate of 93.9%. Previously adapted pretested structured questionnaire was used containing, socio-demographic, clinical, and seizure related factors. Mini-Mental State Examination (MMSE) was used to measure cognitive impairment. A systematic random sampling technique was applied. Data were entered into Epi data version 4.4.2 then exported to SPSS version 24 for analysis. Descriptive statistics, bivariable and multivariable binary logistic regressions with odds ratios and 95% confidence interval were employed. The level of significance of association was determined at a p-value &lt; 0.05.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Prevalence of cognitive impairment in this study was 69.2% (95%CI; 65.4, 73.1). Rural residents (AOR = 4.16,95%CI, 1.99,8.67), respondents who couldn\u2019t read and write (AOR = 2.62, 95%CI; 1.24, 5.5,) longer duration of seizure disorder (AOR = 4.59,95%CI; 2.01,10.52), taking combined Phenobarbital and Phenytoin (AOR = 4.69,95%CI; 1.88,11.69), having history of head injury (AOR = 3.29,95%CI;1.30,8.32), having depression (AOR = 4.76,95%CI;2.83,7.98), and anxiety (AOR = 3.11,95%CI; 1.58,6.12) were significantly associated with cognitive impairment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Prevalence of cognitive impairment in this study was high. Regular neuropsychiatric assessment of patients with epilepsy should be encouraged especially for those participants with longer durations of illness, who are rural residents, who take combined Phenobarbital and Phenytoin, participants who had a history of head injury, depression, and anxiety.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0278908","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T18:31:23Z","timestamp":1670610683000},"page":"e0278908","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cognitive adverse effects of epilepsy and its predictors attending outpatient department of South Gondar zone hospitals, Amhara Region, Ethiopia 2020 \/2021"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1241-4468","authenticated-orcid":true,"given":"Sintayehu","family":"Asnakew","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getasew","family":"Legas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amsalu","family":"Belete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fitalew Tadele","family":"Admasu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getachew Yideg","family":"Yitbarek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tigabu Munye","family":"Aytenew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biruk","family":"Demise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eshetie Molla","family":"Alemu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muluken Adela","family":"Alemu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wubet Alebachew","family":"Bayih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dejen Getaneh","family":"Feleke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ermias Sisay","family":"Chanie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binyam Munye","family":"Birhane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demewoz","family":"Kefale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,12,9]]},"reference":[{"issue":"10","key":"pone.0278908.ref001","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1111\/j.1528-1157.1995.tb00952.x","article-title":"Public perceptions about epilepsy","volume":"36","author":"WM McLin","year":"1995","journal-title":"Epilepsia"},{"issue":"3","key":"pone.0278908.ref002","doi-asserted-by":"crossref","first-page":"235","DOI":"10.4314\/ejhd.v16i3.9821","article-title":"Primary care treatment of epilepsy in rural Ethiopia","volume":"16","author":"S Berhanu","year":"2002","journal-title":"Ethiopian Journal of Health Development"},{"key":"pone.0278908.ref003","volume-title":"Atlas: Epilepsy Care in the World","author":"Diseases OMdlSPfN, Organization WH, Epilepsy GCa, Diseases PfN, Neuroscience, Epilepsy IBf","year":"2005"},{"issue":"4","key":"pone.0278908.ref004","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1006\/ebeh.2000.0104","article-title":"The ILAE\/IBE\/WHO Global Campaign against epilepsy: bringing epilepsy \u201cOut of the Shadows\u201d","volume":"1","author":"EH Reynolds","year":"2000","journal-title":"Epilepsy & Behavior"},{"issue":"6","key":"pone.0278908.ref005","doi-asserted-by":"crossref","first-page":"243","DOI":"10.5698\/1535-7511-12.6.243","article-title":"Introduction to institute of medicine report: epilepsy across the spectrum: promoting health and understanding","volume":"12","author":"M Jacobs","year":"2012","journal-title":"Epilepsy currents"},{"issue":"5","key":"pone.0278908.ref006","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1111\/j.1528-1167.2009.02481.x","article-title":"Estimation of the burden of active and life\u2010time epilepsy: a meta\u2010analytic approach","volume":"51","author":"AK Ngugi","year":"2010","journal-title":"Epilepsia"},{"issue":"9848","key":"pone.0278908.ref007","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1016\/S0140-6736(12)61381-6","article-title":"Epilepsy in poor regions of the world","volume":"380","author":"CR Newton","year":"2012","journal-title":"The Lancet"},{"issue":"3","key":"pone.0278908.ref008","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/S1474-4422(13)70003-6","article-title":"Prevalence of active convulsive epilepsy in sub-Saharan Africa and associated risk factors: cross-sectional and case-control studies","volume":"12","author":"AK Ngugi","year":"2013","journal-title":"The Lancet Neurology"},{"issue":"5","key":"pone.0278908.ref009","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.seizure.2007.11.028","article-title":"Prevalence, incidence and risk factors of epilepsy in older children in rural Kenya","volume":"17","author":"V Mung\u2019ala-Odera","year":"2008","journal-title":"Seizure"},{"issue":"3","key":"pone.0278908.ref010","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.seizure.2006.01.004","article-title":"The prevalence of epilepsy in the Zay Society, Ethiopia\u2014an area of high prevalence","volume":"15","author":"S Almu","year":"2006","journal-title":"Seizure"},{"key":"pone.0278908.ref011","doi-asserted-by":"crossref","DOI":"10.17226\/13379","volume-title":"Epilepsy Across the Spectrum: Promoting Health and Understanding","author":"M England","year":"2012"},{"key":"pone.0278908.ref012","article-title":"Desk reference to the diagnostic criteria from DSM-5\u00ae: American Psychiatric Pub","author":"AP Association","year":"2014"},{"issue":"1","key":"pone.0278908.ref013","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1002\/ana.20872","article-title":"Cognitive prognosis in chronic temporal lobe epilepsy","volume":"60","author":"BP Hermann","year":"2006","journal-title":"Annals of neurology"},{"key":"pone.0278908.ref014","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1111\/j.1528-1167.2006.00702.x","article-title":"Cognitive outcomes in patients with chronic temporal lobe epilepsy","volume":"47","author":"C Helmstaedter","year":"2006","journal-title":"Epilepsia"},{"issue":"5","key":"pone.0278908.ref015","doi-asserted-by":"crossref","first-page":"348","DOI":"10.2350\/06-08-0154.1","article-title":"Lack of evidence for a causal relationship between hypoxic-ischemic encephalopathy and subdural hemorrhage in fetal life, infancy, and early childhood","volume":"10","author":"RW Byard","year":"2007","journal-title":"Pediatric and Developmental Pathology"},{"issue":"4","key":"pone.0278908.ref016","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.seizure.2006.02.010","article-title":"Cognitive impairment in epilepsy: state of affairs and clinical relevance","volume":"15","author":"AP Aldenkamp","year":"2006","journal-title":"Seizure-European Journal of Epilepsy"},{"issue":"8","key":"pone.0278908.ref017","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s00415-012-6526-2","article-title":"Should cognition be screened in new-onset epilepsies? A study in 247 untreated patients","volume":"259","author":"J-A Witt","year":"2012","journal-title":"Journal of neurology"},{"key":"pone.0278908.ref018","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.yebeh.2016.01.011","article-title":"Cognitive impairment in older adults with epilepsy: characterization and risk factor analysis","volume":"56","author":"LA Miller","year":"2016","journal-title":"Epilepsy & Behavior"},{"key":"pone.0278908.ref019","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.jns.2019.10.903","article-title":"Factors that influence cognitive function in epilepsy patients at neurology clinic Mohammad Hoesin Hospital Palembang","volume":"405","author":"S Handayani","year":"2019","journal-title":"Journal of the Neurological Sciences"},{"key":"pone.0278908.ref020","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.18203\/2320-6012.ijrms20191463","article-title":"Cross sectional study to determine the cognitive impairment among epilepsy patients","volume":"7","author":"V Kumar","year":"2019","journal-title":"Int J Res Med Sci"},{"key":"pone.0278908.ref021","article-title":"Cognitive Disorders in Patients with Epilepsy Attending at Neurology Outpatient Clinics","author":"AA Dabilgou","year":"2019","journal-title":"A Multicenter Prospective Cross-Sectional Study from Burkina Faso"},{"issue":"3","key":"pone.0278908.ref022","doi-asserted-by":"crossref","first-page":"405","DOI":"10.4103\/0976-3147.181488","article-title":"A community-based case\u2013control study of prevalence and pattern of cognitive impairments in patients with epilepsy residing in South-Eastern Nigeria","volume":"7","author":"EO Arinzechi","year":"2016","journal-title":"Journal of neurosciences in rural practice"},{"key":"pone.0278908.ref023","article-title":"Cognition and Memory Impairment Among Patients of Epilepsy in Pakistan-The Role of Conventional and Newer Anti-Epileptics","author":"M Malik"},{"issue":"5","key":"pone.0278908.ref024","doi-asserted-by":"crossref","first-page":"00155","DOI":"10.15406\/jnsk.2016.04.00155","article-title":"Prevalence of cognitive adverse outcomes in epileptic outpatients","volume":"4","author":"M. Merkena","year":"2016","journal-title":"J Neurol Stroke"},{"issue":"2","key":"pone.0278908.ref025","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.yebeh.2012.06.016","article-title":"Epilepsy across the spectrum: Promoting health and understanding.: A summary of the Institute of Medicine report","volume":"25","author":"MJ England","year":"2012","journal-title":"Epilepsy & Behavior"},{"issue":"3","key":"pone.0278908.ref026","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.yebeh.2010.07.027","article-title":"The prevention research centers\u2019 managing epilepsy well network","volume":"19","author":"CK DiIorio","year":"2010","journal-title":"Epilepsy & Behavior"},{"key":"pone.0278908.ref027","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.yebeh.2003.11.004","article-title":"Neuropsychological effects of seizures","volume":"5","author":"CB Dodrill","year":"2004","journal-title":"Epilepsy & Behavior"},{"key":"pone.0278908.ref028","first-page":"457","article-title":"Clinical neuropsychology and neocortical epilepsies","volume":"84","author":"M. Jones-Gotman","year":"2000","journal-title":"Advances in neurology"},{"key":"pone.0278908.ref029","first-page":"455","volume-title":"Progress in brain research. 135","author":"H Jokeit","year":"2002"},{"issue":"3","key":"pone.0278908.ref030","first-page":"239","article-title":"Population norms for the mini-mental state examination in Ethiopia","volume":"49","author":"SA Gugssa","year":"2011","journal-title":"Ethiop Med J"},{"issue":"3","key":"pone.0278908.ref031","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d: a practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"MF Folstein","year":"1975","journal-title":"Journal of psychiatric research"},{"issue":"6","key":"pone.0278908.ref032","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale","volume":"67","author":"AS Zigmond","year":"1983","journal-title":"Acta psychiatrica scandinavica"},{"issue":"6","key":"pone.0278908.ref033","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1111\/j.1360-0443.2007.02114.x","article-title":"Validation of the alcohol, smoking and substance involvement screening test (ASSIST)","volume":"103","author":"R Humeniuk","year":"2008","journal-title":"Addiction"},{"key":"pone.0278908.ref034","article-title":"Diagnostic and statistical manual of mental disorders: DSM-5","author":"M Guha","year":"2014","journal-title":"Reference Reviews"},{"issue":"6","key":"pone.0278908.ref035","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1007\/s00038-020-01401-7","article-title":"Which clinical and neuropsychological factors are responsible for cognitive impairment in patients with epilepsy?","volume":"65","author":"D Jar\u010du\u0161kov\u00e1","year":"2020","journal-title":"International Journal of Public Health"},{"issue":"2","key":"pone.0278908.ref036","doi-asserted-by":"crossref","first-page":"5","DOI":"10.21767\/2471-8548.10009","article-title":"Cognitive impairment in patients with temporal lobe epilepsy","volume":"2","author":"F Nouha","year":"2018","journal-title":"J Neuropsychiatry"},{"issue":"3","key":"pone.0278908.ref037","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1136\/jnnp.29.3.268","article-title":"Cognitive abilities in relation to frequency of seizures and neuropathology of the temporal lobes in man","volume":"29","author":"C Blakemore","year":"1966","journal-title":"Journal of neurology, neurosurgery, and psychiatry"},{"issue":"10","key":"pone.0278908.ref038","doi-asserted-by":"crossref","first-page":"4267","DOI":"10.18203\/2320-6012.ijrms20174187","article-title":"Psychiatric morbidity in epilepsy","volume":"5","author":"P Singh","year":"2017","journal-title":"Int J Res Med Sci"},{"issue":"2","key":"pone.0278908.ref039","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1111\/j.0013-9580.2005.02104.x","article-title":"Cognitive functioning in community dwelling older adults with chronic partial epilepsy","volume":"46","author":"RC Martin","year":"2005","journal-title":"Epilepsia"},{"issue":"8","key":"pone.0278908.ref040","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1176\/appi.ajp.160.8.1516","article-title":"Untreated depression and hippocampal volume loss","volume":"160","author":"YI Sheline","year":"2003","journal-title":"American journal of psychiatry"},{"issue":"4","key":"pone.0278908.ref041","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1093\/cercor\/12.4.386","article-title":"Reduced neuronal size and glial cell density in area 9 of the dorsolateral prefrontal cortex in subjects with major depressive disorder","volume":"12","author":"D Cotter","year":"2002","journal-title":"Cerebral cortex"},{"issue":"5","key":"pone.0278908.ref042","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S0361-9230(01)00527-5","article-title":"Glial cell abnormalities in major psychiatric disorders: the evidence and implications","volume":"55","author":"DR Cotter","year":"2001","journal-title":"Brain research bulletin"},{"key":"pone.0278908.ref043","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.nbd.2018.07.018","article-title":"Affective, neurocognitive and psychosocial disorders associated with traumatic brain injury and post-traumatic epilepsy","volume":"123","author":"BD Semple","year":"2019","journal-title":"Neurobiology of disease"},{"issue":"9","key":"pone.0278908.ref044","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1111\/j.1532-5415.1992.tb01992.x","article-title":"The mini\u2010mental state examination: a comprehensive review","volume":"40","author":"TN Tombaugh","year":"1992","journal-title":"Journal of the American Geriatrics Society"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0278908","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T18:31:43Z","timestamp":1670610703000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0278908"}},"subtitle":[],"editor":[{"given":"Muhammad Junaid","family":"Farrukh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,12,9]]},"references-count":44,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0278908","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,9]]}}}