Psychiatric comorbidity in epilepsy: a population-based analysis.
OBJECTIVE
The estimated prevalence of mental health disorders in those with epilepsy in the general population varies owing to differences in study methods and heterogeneity of epilepsy syndromes. We assessed the population-based prevalence of various psychiatric conditions associated with epilepsy using a large Canadian national population health survey.


METHODS
The Canadian Community Health Survey (CCHS 1.2) was used to explore numerous aspects of mental health in persons with epilepsy in the community compared with those without epilepsy. The CCHS includes administration of the World Mental Health Composite International Diagnostic Interview to a sample of 36,984 subjects. Age-specific prevalence of mental health conditions in epilepsy was assessed using logistic regression.


RESULTS
The prevalence of epilepsy was 0.6%. Individuals with epilepsy were more likely than individuals without epilepsy to report lifetime anxiety disorders or suicidal thoughts with odds ratio of 2.4 (95% CI = 1.5-3.8) and 2.2 (1.4-3.3), respectively. In the crude analysis, the odds of lifetime major depression or panic disorder/agoraphobia were not greater in those with epilepsy than those without epilepsy, but the association with lifetime major depression became significant after adjustment for covariates.


CONCLUSIONS
In the community, epilepsy is associated with an increased prevalence of mental health disorders compared with the general population. Epilepsy is also associated with a higher prevalence of suicidal ideation. Understanding the psychiatric correlates of epilepsy is important to adequately manage this patient population.
Division of Neurology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Jose F
JF
Tellez-Zenteno
Scott B
SB
Patten
Nathalie
N
Jetté
Jeanne
J
Williams
Samuel
S
Wiebe
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D003625:Data Collection; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D017831:Diagnosis, Dual (Psychiatry); D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data