Physical and mental health comorbidities of epilepsy: Population-based cross-sectional analysis of 1.5 million people in Scotland

Weatherburn, Christopher J; Heath, Craig; Mercer, Stewart W; Guthrie, Bruce

doi:10.1016/j.seizure.2016.11.013

Cited by 58 publications

(49 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The systemic stress induced by an NTFx may create an unfavorable physiological environment that exacerbates risk for post‐NTFx complications and premature mortality, through either direct or indirect mechanisms . Individuals with epilepsy are particularly susceptible to post‐NTFx complications because of their greater lifetime burden of unhealthful aging, as evidenced by an elevated prevalence of chronic diseases in adulthood . Therefore, adults with epilepsy may already have a compromised physiological environment and skeletal fragility (eg, history of NTFx), and sustaining an NTFx may further exacerbate risk of post‐NTFx complications and premature mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, adults with epilepsy may have greater risk of post‐NTFx mortality because of their poor skeletal development and preservation throughout the lifespan and other unhealthful aging processes. Specifically, individuals with epilepsy have greater risk of chronic diseases across biological systems, including cardiometabolic, respiratory, gastrointestinal, liver, and other neurological diseases, as well as a variety of mental health disorders . Furthermore, there is strong evidence to suggest that individuals with epilepsy have greater risk of premature mortality compared to individuals without epilepsy .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The mortality burden attributable to nontrauma fracture for privately insured adults with epilepsy

et al. 2020

View full text Add to dashboard Cite

Objective: Individuals with epilepsy have poor bone development and preservation throughout the lifespan and are vulnerable to nontrauma fracture (NTFx) and post-NTFx complications. However, no studies have examined the contribution of NTFx to mortality among adults with epilepsy. The objective was to determine whether NTFx is a risk factor for mortality among adults with epilepsy. Methods: Data from 2011 to 2016 were obtained from Optum Clinformatics Data Mart, a nationwide claims database from a single private payer in the United States.Diagnosis codes were used to identify adults (≥18 years old) with epilepsy, NTFx, and covariates (demographics and pre-NTFx cardiovascular disease, respiratory disease, diabetes, chronic kidney disease, cancer). Crude mortality rate per 100 person-years was estimated. Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs) were determined for mortality, comparing epilepsy and NTFx (EP + NTFx; n = 11 471), epilepsy without NTFx = 6.8 million)after adjusting for covariates. Results: The 3-, 6-, and 12-month crude mortality rates were highest among EP + NTFx (12-month mortality rate = 8.79), followed by without EP + NTFx (12month mortality rate = 4.80), EP without NTFx (12-month mortality rate = 3.06), and without EP without NTFx (12-month mortality rate = 0.47). After adjustments, the mortality rate was elevated for EP + NTFx for all time points compared to EP without NTFx (eg, 12-month HR = 1.70, 95% CI = 1.58-1.85), without EP + NTFx (eg, 12-month HR = 1.41, 95% CI = 1.32-1.51), and without EP without NTFx (eg, 12-month HR = 5.23, 95% CI = 4.88-5.60). Stratified analyses showed higher adjusted HRs of 12-month mortality for EP + NTFx for all NTFx sites (ie, vertebral column, hip, extremities), all age categories (young, middle-aged, older), and for both women and men. Significance: Among adults with epilepsy and compared to adults without epilepsy, NTFx is associated with a higher 12-month mortality rate. Findings suggest that NTFx may be a robust risk factor for mortality among adults with epilepsy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The mortality burden attributable to nontrauma fracture for privately insured adults with epilepsy

et al. 2020

View full text Add to dashboard Cite

show abstract

“…[3][4][5] Furthermore, mental health comorbidities of epilepsy are associated with socioeconomic deprivation. 6 Thus, the interesting and important findings of Manouze et al 1 in the pilocarpine model of temporal lobe epilepsy (TLE) are clinically relevant. Furthermore, in my own experience, these findings have a practical preclinical consequence because, particularly for complex and laborious pharmacological studies, the use of single-housed rodents with high frequency of spontaneous recurrent seizures (SRSs) and prominent behavioral and cognitive alterations reduces the group size that is needed to obtain significant treatment effects, which, of course, is an animal welfare issue, which is discussed in the following.…”

Section: Social Deprivation Is a Well-known Risk Factor Of Epilepsymentioning

confidence: 99%

Consequences of housing conditions and interindividual diversity in rodent models of acquired epilepsy

Löscher¹

2019

Epilepsia

View full text Add to dashboard Cite

“…One potential patient characteristic that may differentiate patients with PNES and ES is the prevalence of comorbid psychopathology. Multiple studies have suggested increased prevalence of psychiatric comorbidity in ES patients [6][7][8][9] compared to the general population, and one meta-analysis has found an increased risk of psychiatric comorbidity in PNES compared to ES [10]. Specifically, the existing literature suggests an increased prevalence of depression [11] and anxiety [6] in ES patients compared to healthy controls.…”

Section: Introductionmentioning

confidence: 99%

Distinct psychopathology profiles in patients with epileptic seizures compared to non-epileptic psychogenic seizures

Wang

Leong

Johnstone

et al. 2019

Preprint

View full text Add to dashboard Cite

Objective: Similarities in clinical presentations between epileptic seizures (ES) and psychogenic non-epileptic seizures (PNES) produces a risk of misdiagnosis. Video-EEG monitoring (VEM) is the diagnostic gold standard, but involves significant cost and time commitment, suggesting a need for more efficient screening tools. Methods: 628 patients were recruited from an inpatient VEM unit; 293 patients with ES, 158 with PNES, 31 both ES and PNES, and 146 non-diagnostic. Patients completed the SCL-90-R, a standardised 90-item psychopathology instrument. Bayesian linear models were computed to investigate whether SCL-90-R domain scores or the overall psychopathology factor p differed between groups. Receiver operating characteristic (ROC) curves were computed to investigate the PNES classification accuracy of each domain score and p. A machine learning algorithm was also used to determine which subset of SCL-90-R items produced the greatest classification accuracy. Results: Evidence was found for elevated scores in PNES compared to ES groups in the symptom domains of anxiety (b = 0.47, 95%HDI = [0.10, 0.80]), phobic anxiety (b = 1.32, 95%HDI = [0.98, 1.69]), somatisation (b = 0.84, 95%HDI = [0.49, 1.20]), and the general psychopathology factor p (b = 1.35, 95%HDI = [0.86, 1.82]). While somatisation scores produced the highest classification accuracy (AUC = 0.74, 95%CI = [0.69, 0.79]), it was not sufficient for use as a screening or diagnostic test. The genetic algorithm produced a 6-item subset from the SCL-90-R, however on cross-validation these items did not display improved classification accuracy (AUC = 0.73, 95%CI = [0.64, 0.82]). Significance: Our study demonstrated differences between ES and PNES patients using a validated psychopathology instrument. These differences were not large enough to provide sufficient classification accuracy. However, these findings suggest that elevations in self-reported somatisation, general anxiety, or phobic anxiety should raise suspicion of PNES in clinical settings.

show abstract

Physical and mental health comorbidities of epilepsy: Population-based cross-sectional analysis of 1.5 million people in Scotland

Cited by 58 publications

References 32 publications

The mortality burden attributable to nontrauma fracture for privately insured adults with epilepsy

The mortality burden attributable to nontrauma fracture for privately insured adults with epilepsy

Consequences of housing conditions and interindividual diversity in rodent models of acquired epilepsy

Distinct psychopathology profiles in patients with epileptic seizures compared to non-epileptic psychogenic seizures

Contact Info

Product

Resources

About