NEW RESEARCH SUGGESTS that people with epilepsy are 11 times more likely to die prematurely than the general population.

According to the study, just published in The Lancet, the risk is heightened for individuals with common co-existing psychiatric illnesses, especially depression and alcohol and drug use disorders.

Researchers examined the lives and deaths of almost 70,000 patients with epilepsy over a 41 year period and found that three-quarters of those who died from accidents or suicide had also been diagnosed with a psychiatric condition during their lifetime.

Led by Seena Fazel from the University of Oxford, the study tracked 69,995 people with epilepsy born in Sweden between 1954 and 2009 for up to 41 years.

The causes of death were assessed and compared with 660,869 age-matched and sex-matched individuals from the general population, as well as 81,396 unaffected siblings of people with epilepsy (in order to account for the influence of genetic or early environmental risk factors).

Roughly 9 per cent (or 6,155) of people with epilepsy died during follow up compared with 0.7 per cent (or 4,892) of people from the general population.

Cause of death

Deaths from external causes (suicides, vehicle and non-vehicle accidents and assaults) accounted for almost 16 per cent of all deaths in people with epilepsy and were the most common causes of death not linked to the underlying disease process. Of these, 75 per cent also had a diagnosis of mental disorder, with substance misuse (56 per cent) and depression (23 per cent) the largest contributors.

The majority of early deaths from external causes were from suicides, with the odds of death four times higher for those with epilepsy.

When researchers compared patients to their siblings, the risk of early death was much the same as when compared to the general population. According to the authors, this is important as it suggest that epilepsy is an independent risk factor for all-cause and external causes of death.

““Our results have significant public health implications as around 70 million people worldwide have epilepsy, and emphasise that carefully assessing and treating psychiatric disorders as part as part of standard checks in persons with epilepsy could help reduce the risk of premature death in these patients,” said Fazel.

Our study also highlights the importance of suicide and non-vehicle accidents as major preventable causes of death in people with epilepsy.

Ley Sander from University College London Institute of Neurology in London added that management of comorbidities should be part of a holistic approach to the condition.

“The presence of comorbid disorders is associated with increased health-care needs, poorer health-related quality of life, and is a major driver for premature mortality. Prevention, identification, and adequate treatment of comorbid disorders should be an important part of epilepsy management at all levels of care.”

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