Psychiatric Conditions Lead to Premature Death in Patients with Epilepsy

In the July 22nd issue of the journal Lancet, Drs. Fazel and colleagues from the United Kingdom present a compelling research study in which all individuals born in Sweden between 1954 and 2009 with a diagnosis of epilepsy were evaluated for risks and causes of premature mortality and were compared to the general population without epilepsy. The investigators found the following:

• 9% of people with epilepsy died compared to 0.7% of people in the general population.

• Deaths from external causes (not part of the actual condition) accounted for nearly 16% of all deaths among people with epilepsy and were the most common causes of death.

• Of the epilepsy patients who died from external causes, 75% also had diagnosed mental disorders with 56% having substance abuse and 23% having depression.

• People with both epilepsy and substance abuse were 22 times more likely to die from external causes than people with neither condition.

• The majority of deaths from external causes were from suicides, and people with epilepsy were four times more likely to commit suicide than people in the general population.

• Of those deaths, 15.8% were from external causes with high odds for non-vehicle accidents and suicide.

• Of those who died from external causes, 75% had other comorbid psychiatric disorders with strong associations in individuals with depression and substance abuse compared to patients who did not have epilepsy.

The investigators concluded that

• Reducing premature mortality from external causes of death should be a priority in epilepsy management.

• Psychiatric co-morbidities play an important part in the premature mortality seen in epilepsy.

• Health services need to be there to help individuals.