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VNA of Care New England

Psych Comorbidity Contributes to Premature Death in Epilepsy

Most of those with epilepsy who die from external causes have comorbid psychiatric disorders
MONDAY, July 22 (HealthDay News) -- For patients with epilepsy, psychiatric comorbidity contributes to premature mortality from external causes, according to a study published online July 22 in The Lancet.
Seena Fazel, M.D., from the University of Oxford in the United Kingdom, and colleagues assessed the prevalence and risks of premature mortality from external causes (e.g., suicide, accidents, assaults) among 69,995 Swedish individuals with epilepsy, with and without psychiatric comorbidity. Patients were compared with 660,869 age- and sex-matched controls from the general population and with 81,396 unaffected siblings.
During follow-up, the researchers found that 8.8 percent of people with epilepsy died, at a median age of 34.5 years. The odds of premature mortality were significantly increased compared with general population controls (adjusted odds ratio [aOR], 11.1) and with unaffected siblings (aOR, 11.4). External causes accounted for 15.8 percent of these deaths, with high odds of non-vehicle accidents and suicide (aOR, 5.5 and 3.7, respectively). Most of those who died from external causes (75.2 percent) had comorbid psychiatric disorders, with strong correlations seen for those with concurrent depression and substance misuse (aOR, 13.0 and 22.4, respectively), compared to those without epilepsy and with no psychiatric comorbidity.
"In summary, psychiatric comorbidity has an important role in the premature mortality seen in epilepsy," the authors write. "Reducing premature mortality from external causes of death should be a priority in epilepsy management."
Abstract (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60899-5/abstract )Full Text (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60899-5/fulltext )Editorial (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61136-8/fulltext )
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