People with epilepsy face high burden of psychiatric comorbidities

Psychiatric disorders such as anxiety, depression, schizophrenia, autism spectrum disorder, and alcohol dependence, among others, are more prevalent among people with epilepsy than among those who do not have the neurological condition, according to the results of a meta-analysis.

Researchers searched multiple online databases for epidemiological studies in which the prevalence of psychiatric disorders among people with epilepsy were examined. They reviewed the abstracts in duplicate and extracted data using a standardized electronic form.

Twenty-seven studies met the eligibility criteria. Of the studies, 14 were conducted in Europe, 10 in North America, two in Asia and Oceania, and one in Latin America. The total population comprised 565,443 people with epilepsy and 13,434,208 individuals without the condition (control).

Pooled data showed that compared with controls, people with epilepsy had significantly increased odds of psychiatric disorders. These included anxiety (odds ratio [OR], 2.11, 95 percent confidence interval [CI], 1.73–2.58), depression (OR, 2.45, 95 percent CI, 1.94–3.09), bipolar disorder (OR, 3.12, 95 percent CI, 2.23–4.36), suicidal ideation (OR, 2.25, 95 percent CI, 1.75–2.88), psychotic disorder (OR, 3.98, 95 percent CI, 2.57–6.15), schizophrenia (OR, 3.72, 95 percent CI, 2.44–5.67), obsessive-compulsive disorder (OR, 2.71, 95 percent CI, 1.76–4.15), post-traumatic stress disorder (OR, 1.76, 95 percent CI, 1.14–2.73), eating disorders (OR, 1.87, 95 percent CI, 1.73–2.01), alcohol misuse (OR, 3.64, 95 percent CI, 2.27–5.83) and dependence (OR, 4.94, 95 percent CI, 3.50–6.96), substance use disorder (OR, 2.75, 95 percent CI, 1.61–4.72), autism spectrum disorder (OR, 10.67, 95 percent CI, 6.35–17.91), and attention-deficit/hyperactivity disorder (OR, 3.93, 95 percent CI, 3.80–4.08).

Based on the Newcastle-Ottawa Scale, the studies had an acceptable methodological risk of bias.

These findings highlight the need to appropriately identify and treat psychiatric comorbidity in epilepsy to manage patients effectively and improve quality of life, according to the researchers.