Behavioral health in young adults with epilepsy: Implications for transition of care.
Neurodevelopmental and behavioral health disorders commonly occur with epilepsy, yet risk for young adults is unknown. The aim of this study was to determine the distribution and risk characteristics of neurodevelopmental and behavior health comorbidities among young adults with epilepsy compared with those among young adults with migraine and healthy controls.



A case-control study examining hospital admission, outpatient, and emergency department (ED) visits for young adults with an ICD-9-CM diagnosis of epilepsy, migraine, or lower extremity fracture (LEF) was conducted. The association of epilepsy, migraine, or LEF with comorbidities was evaluated with univariate and multivariate polytomous logistic regression.



From 2000 to 2013, 29,139 young adults ages 19 to 25years were seen in hospitals and EDs for epilepsy (5666), migraine (17,507), or LEF (5966). Young adults with epilepsy had higher proportions of behavioral health comorbidities (51.8%) compared with controls with migraine (37.6%) or LEF (21.6%). In young adults with epilepsy compared with migraine, the increased risk of having any behavioral health comorbidity was 76%, and neurodevelopmental comorbidity was 297%. After adjustment, young adults with epilepsy showed significantly higher odds of each behavioral health comorbidity compared with controls with migraine and LEF.



Young adults with epilepsy are particularly susceptible to behavioral health and neurodevelopmental disorders. Results are discussed within the context of transition to adult care.
College of Nursing, Medical University of South Carolina, United States; Comprehensive Epilepsy Program, Medical University of South Carolina, United States; Department of Pediatrics, Medical University of South Carolina, United States. Electronic address: wagnerjl@musc.edu.
Janelle L
JL
Wagner
Department of Public Health Sciences, Medical University of South Carolina, United States.
Dulaney A
DA
Wilson
Department of Neurosurgery, Medical University of South Carolina, United States.
Tanja
T
Kellermann
College of Nursing, Medical University of South Carolina, United States; Comprehensive Epilepsy Program, Medical University of South Carolina, United States; Department of Pediatrics, Medical University of South Carolina, United States.
Gigi
G
Smith
Department of Public Health Sciences, Medical University of South Carolina, United States.
Angela M
AM
Malek
Comprehensive Epilepsy Program, Medical University of South Carolina, United States; Department of Neurosciences, Medical University of South Carolina, United States.
Braxton
B
Wannamaker
Department of Public Health Sciences, Medical University of South Carolina, United States.
Anbesaw W
AW
Selassie
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000639:trends; D004827:Epilepsy / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D015438:Health Behavior; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D065886:Neurodevelopmental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D010360:Patient Transfer / Q000379:methods* / Q000639:trends; D012307:Risk Factors; D055815:Young Adult
Behavioral health disorders; Neurodevelopmental disorders; Pediatric epilepsy; Psychiatric disorders; Transition to adult care