The incidence of first provoked and unprovoked seizure in pediatric patients with and without psychiatric diagnoses.
OBJECTIVE
To estimate the rate of new-onset afebrile provoked and unprovoked seizure in a general pediatric population and subgroups of patients with and without psychiatric diagnoses other than attention deficit hyperactivity disorder (ADHD).


METHODS
A retrospective cohort study of 133,440 pediatric patients, between the ages of 6 and 17 years, and without history of seizure or prior use of anticonvulsant medications, with follow-up during 2003. The data source for this study was Ingenix's research database containing pharmacy and medical claims for members of a large US-based managed care organization. The main outcome measure was new-onset nonfebrile seizure. Incidence rates of seizure and 95% confidence intervals (CI) were calculated and expressed as rates per 100,000 person-years.


RESULTS
There were 132 new-onset provoked and unprovoked seizures in 78,423 person-years of follow-up among the general pediatric population sample. The incidence rate of seizure among the general pediatric population was 168 per 100,000 p-y (95% CI 141-200). The incidence rate of seizure among patients without psychiatric diagnoses was 149 per 100,000 p-y (95% CI 122-180). The incidence rate of seizure among patients with psychiatric diagnoses other than ADHD was 513 per 100,000 p-y (95% CI 273-878). There were increases in the incidence rates of seizure in all of the seizure risk factor groups, but this was more pronounced among males ages 6-12 with psychiatric diagnoses.


CONCLUSIONS
The results of this study are consistent with previous reports showing that pediatric patients with psychiatric disorders have a higher incidence rate of seizure than the general pediatric population.
McAfee
Andrew T
AT
i3 Drug Safety, Waltham, Massachusetts 02451, USA. andrew.mcafee@i3drugsafety.com
Chilcott
Karen E
KE
Johannes
Catherine B
CB
Hornbuckle
Ken
K
Hauser
W Allen
WA
Walker
Alexander M
AM
D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D019992:Databases as Topic / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000188:drug therapy / Q000453:epidemiology*; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
D000927:Anticonvulsants