Seizure risk increased before and after psychiatric hospitalization
MedWire News: Results from a Swedish study suggest the risk for unprovoked epileptic seizures is significantly increased before and after hospitalization for psychiatric disorders.
"Several, mainly cross-sectional, studies have demonstrated that psychiatric disease is more common among people with epilepsy than in the general population. This includes anxiety disorders, bipolar disorders, psychoses, and depression," explain Cecilia Adelöw and colleagues from the Karolinska Institute in Stockholm.
But they add that the direction of the association is less clear.
To investigate the temporal sequence in the relationship between epilepsy and psychiatric disorders, the team used the Stockholm Epilepsy Register to identify 1885 individuals who experienced a first, unprovoked seizure between 2000 and 2008. For each case, eight controls (15,080 in total) matched for gender and year of diagnosis were randomly selected from the Stockholm County population register.
According to the Swedish Hospital Discharge Registry, 3.7% of the seizure group had a discharge diagnosis of depression, psychosis, anxiety disorder, or bipolar disorder, compared with 1.4% of controls.
The researchers found that the risk for unprovoked seizures was significantly elevated after psychiatric hospitalization, at age-adjusted odds ratios (ORs) of 4.5 within 0-2 years of hospitalization, and 1.9 thereafter, compared with no psychiatric hospitalization.
The ORs for unprovoked seizures before psychiatric hospitalization were also increased, at 3.9 for up to 2 years before hospitalization, 2.7 for 2-5 years before hospitalization, and 2.6 for more than 5 years before hospitalization.
The researchers note that the overall risk for seizures after psychiatric hospitalization was highest among patients with bipolar disorder or anxiety, both at an OR of 2.7.
Adelöw and team conclude: "Our results support the hypothesis of common pathogenic mechanisms for epilepsy and some psychiatric conditions and prompt further studies exploring the nature of this shared etiology."
They add: "From the clinical point of view, physicians need to be aware that patients with severe psychiatric conditions… are at increased risk of developing epilepsy and vice versa."
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By Mark Cowen