PONE-D-20-08958

Comorbid mental disorders and quality of life of people with epilepsy attending primary health care clinics in rural Ethiopia.

PLOS ONE

Dear Dr. Tsigebrhan,

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Kind regards,

Thach Duc Tran, M.Sc., Ph.D.

Academic Editor

PLOS ONE

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Reviewers' comments:

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Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

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Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Very interesting and well conducted study about mental health issues among patients with epilepsy. However, a few minor correction will improve the manuscript and make and even better read.

The manuscript would clearly improve by undergoing anti-verbiage drive. It is full of unnecessary words and repetitions which could be removed without compromising the clarity of the report.

Could the authors please avoids the use of PWE as this is a matter of irritation to many patients with epilepsy, in my experience. Just spell it out in full. Also, the authors should remember that this is report on epilepsy so there is no need to repeat this at each paragraph.

The author don't seem to be cognizant with the concept of keywords. Indeed, any term or word which is already in the title should not be in the list of keywords. Could this be corrected?

Reviewer #2: The authors present a cross-sectional study on the prevalence of mental comorbidities in persons with epilepsy from a region in Ethiopia. The study is of interest for clinicians and researchers especially as it is from an area from which only limited data is available. The two-staged approach of identifying study participants and the methods of diagnostic assessment and data collection are as well of interest. I have only a few comments:

Epilepsy duration should be taken into account.

I understand about half of the population are Muslims bit the vast majority of study participants is of orthodox religion. Could the authors explain? At least they assessed for religion. Do they see any association with the study results?

Table 2 dos not show any data on anxiety disorder: Could the authors explain?

Discussion is a bit lengthy and extends to statements which are certainly common sense (poverty reduction and improved education are necessary) but their association to the study results is rather loose.

The main surprising feature is the smaller proportion of persons with mental comorbidity in comparison to other studies. This might be discussed further. Are there any other factors rather than those discussed by the authors? Do differences in presentation of depression have any consequences for further research?

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Reviewer #1: No

Reviewer #2: Yes: Christian Brandt

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Comorbid mental disorders and quality of life of people with epilepsy attending primary health care clinics in rural Ethiopia.

PONE-D-20-08958R1

Dear Dr. Tsigebrhan,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Thach Duc Tran, M.Sc., Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: (No Response)

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: thanks for revising the manuscript; this is now a much better report and i would not have any further comments.

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: Yes: Christian Brandt