A relationship between depression and epilepsy has been consistently reported in the literature. Most of this research has estimated the proportion of people with depression in epilepsy. More recently, research has focused on determining fast and accurate methods of diagnosing depression in clinical samples. In contrast, there is a relative dearth of research into the treatment of depression in epilepsy using both pharmacological and non-pharmacological methods. Despite this research, there are still gaps in the knowledge base of this association. The literature on depression in epilepsy has not been reviewed and summarized. Screening tools for identifying depression in epilepsy have either not been validated, or have not been validated with a gold standard tool. Finally, patterns of pharmacological and non-pharmacological treatment of depression in epilepsy have not been well characterized. The work reported in this dissertation addresses each of these three knowledge gaps. Based on a systematic review, the overall pooled prevalence of active depression in persons with epilepsy was found to be 23.1% (95% Confidence Interval (CI): 20.6%-28.3%), and the overall odds ratio of active depression in those with epilepsy, relative to those without, was 2.77 (95% CI: 2.09-3.67). Three depression screening tools, one of which was previously not validated, and new cut-points for scoring were explored in a group of 185 persons with epilepsy. Compared to a gold-standard diagnostic interview, the tools with the best overall balance of sensitivity and specificity were the Hospital Anxiety and Depression Scale at a cut-point of seven and the Patient Health Questionnaire with a cut-point of nine. Newly suggested cut-points for scoring performed better than those cut-points recommended for use in the general population. Considering both pharmacological and non- pharmacological treatments for depression in persons with epilepsy, the majority of persons (70.3%) with current depression were not receiving depression-related therapy. Of those treated,
most were receiving non-pharmacological treatments for depression. More persons with a past history of depression (37.2%) were receiving treatment, of which the majority was by pharmacological management. The results of these studies characterize the identification and management of depression, addressing knowledge gaps and providing direction for future research.