Abstracts

A previous epidemiological study has shown that patients with epilepsy have substantial comorbidity of chronic conditions¹. We hypothesized that the somatic multicomorbidity in epilepsy is not specific for epilepsy, but that other chronic conditions share similar comorbidity. We analyzed data from the National Population Health Survey (NPHS, 49,000 respondents) and the Community Health Survey (CHS, 130,882 respondents). Both surveys used probabilistic sampling of the entire Canadian population and explored the presence of 19 common chronic conditions, ascertained through trained personal interviewers. We obtained risk ratios for prevalence of chronic conditions in 4 target disorders that can affect similar age groups: epilepsy, asthma, migraine and diabetes 19 chronic somatic conditions were explored. 13 chronic conditions occurred significantly more frequently in epilepsy patients than in the general population, 10 in asthma, 14 in diabetes and 10 in migraine (Risk ratio [gt]1.0, 95% CI excluded the null value). Chronic conditions with very high prevalence (Risk ratio [gt]2) in our target disorders were: [italic]Epilepsy[/italic]: upper gastrointestinal problems, stroke, urinary incontinence, bowel disorders, chronic fatigue, migraine, pulmonary conditions and heart disease. [italic]Migraine:[/italic] upper gastrointestinal problems, bowel disorders, and chronic fatigue. [italic]Diabetes:[/italic] arthritis, high blood pressure, pulmonary conditions, heart disease, stroke, cataracts, thyroid conditions, cancer and glaucoma. [italic]Asthma:[/italic] pulmonary conditions and chronic fatigue. Epilepsy has the highest somatic comorbidity. It is similar in frequency to Diabetes, a systemic, multiorgan condition. However, the profile is different, only 3 of 8 highly comorbid conditions were shared. Only fatigue and pulmonary conditions occurred in at least three of our target disorders. Comorbid conditions in migraine and asthma were infrequent, but similar in type to epilepsy. We conclude that somatic comorbidity in epilepsy is as high as in systemic, multiorgan disorders, and that it cannot be explained simply as a function of its chronicity. We discuss methodological issues and validity of findings
1. Gaitatzis A, Carroll K, Majeed A, Sander W. The epidemiology of the comorbidity of epilepsy in the general population. Epilepsia 2004; 45(12):1613-1622.