Psychiatric Conditions Lead to Premature Death in Patients with Epilepsy

Wednesday, August 28, 2013

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.

Authored by: Joseph I. Sirven MD on 8/2013

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