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PSYCHIATRIC CONDITIONS LEAD TO PREMATURE DEATH IN PATIENTS WITH EPILEPSY

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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.
    by Joseph I. Sirven, MD
    Editor-in-Chief, epilepsy.com
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