Individuals suffering from epilepsy are 10 times more likely to die at a younger age than the general population, and undertreated mental illness may influence this connection, according to new research.
Epilepsy is a neurological disorder characterized by seizures. The study from Karolinska Institutet in Sweden and Oxford University shows a strong connection between early death and mental illness in epilepsy patients, with 40 percent of patients with epilepsy having received a lifetime psychiatric diagnosis compared with only 10 percent in the general population.
The difference is much greater than previously thought and may have significant implications for epilepsy management.
For the study, published in the journal The Lancet, researchers evaluated 69,995 individuals with epilepsy born in Sweden between 1954 and 2009. These patients were followed for over 41 years, between the years of 1969 and 2009.
Researchers compared mortality and causes of death with those among 660,869 age- and sex-matched control individuals from the general population. During follow-up, 8.8 percent of epilepsy patients died compared with 0.7 percent of matched people from the general population.
Following the number of deaths directly related to the underlying brain disease, accidents or suicide were the most common causes of death among people with epilepsy.
Together, these causes were accountable for 16 percent of all deaths, and three-fourths were among epilepsy patients who also had a mental illness. The chances of a person with epilepsy committing suicide were four times greater than the general population.
To investigate the influence of background factors, including genetic risk and upbringing, researchers also analyzed the outcome of unaffected siblings of epilepsy patients.
Unaffected siblings of those with epilepsy did not have a greater risk of premature death compared with general population controls. This provides more evidence that epilepsy as a brain disease is an independent risk factor for death by any cause.
“Reducing premature mortality from external causes of death including suicide remains an important issue in epilepsy management,” said study co-author Professor Niklas Långström of Karolinska Institutet.
“Our results suggest that preventive efforts should focus on patients with psychiatric comorbidities, particularly depression and substance abuse.”
The study was funded by the Wellcome Trust and the Swedish Research Council.
Source: Karolinska Institutet