Abstracts

Rationale: Epilepsy affects about 50 million people globally. Epilepsy and psychiatric disorders share common neurobiologic pathways. There is also a genetic predisposition for the development of some epilepsy syndromes and psychiatric disorders. Prior studies have revealed that people with epilepsy are more likely to develop psychiatric disorders, particularly depression. Some studies have also found psychiatric symptoms preceding the first seizure. The objective of this study was to assess the association of epilepsy with various psychiatric disorders, age of mental health symptom onset, and family history of psychiatric disorders. Methods: A secondary data analysis was performed of the National Comorbidity Survey Replication (NCS-R) data. The survey was completed by 9,282 English-speaking adult residents of the continental United States between February 2001 and April 2003. There were two parts to the interview. 9,282 respondents completed part-I of the NCS-R. Part II was administered to 5,721 respondents who were asked if a health care professional ever told them that they had epilepsy/seizures and the age of onset. Of these 5,721 people, 2014 individuals were asked about family history of mental illness. Comparisons were performed between respondent subgroups of the following: prevalence of DSM-IV lifetime mental disorders, age of mental health symptom onset, and family history of psychiatric disorders in people told to have epilepsy/seizures. Results: Of the 5,721 respondents questioned regarding epilepsy, 136 reported a diagnosis of epilepsy/seizures. Of the 2,014 questioned for a family history of psychiatric disorder, 39 reported a diagnosis of epilepsy/seizures. In the NCS-R sample, persons with epilepsy were found to have a higher prevalence of any DSM-IV lifetime disorder, 86.03/100 in people with epilepsy and 76.01/100 in those without, along with an earlier onset of mental health symptoms (p<0.01). People with epilepsy had a mean age of mental health symptom onset at 12.69 years,compared to people without epilepsy with onset at 15.04 years. At the DSM-IV group level, only substance abuse and impulse control disorders were found to be significantly higher in people with epilepsy (p<0.05). The majority of respondents with epilepsy had onset of mental health symptoms preceding their epilepsy diagnosis. This temporal relationship varied with age of epilepsy diagnosis (p<0.0001). Of the psychiatric disorders reported, a statistically significant association was found exclusively between family history of depression and epilepsy. 13/39 people with epilepsy(33.33%) and 399/1975 people without epilepsy(20.55%) reported a family history of depression(p=0.0511).