People with epilepsy are 11 times more likely to die prematurely than the general population, with the risks highest among those with psychiatric illnesses, such as depression, as well as alcohol and drug use disorders.
The findings, published in The Lancet, are based on an analysis of nearly 70,000 Swedish patients with epilepsy whose medical records were tracked for a 41-year period.
The research, led by University of Oxford scientists, indicated three-quarters of those who died from accidents or suicide had also been diagnosed with a psychiatric condition during their lifetime. The causes of death were assessed and compared with 660,869 individuals from the general population, and more than 81,000 siblings of people with epilepsy to rule out genetic or environmental risk factors.
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Roughly 9 percent of people with epilepsy died during the course of the study, compared with 0.7 percent of people from the general population.
"Our results have significant public health implications as around 70 million people worldwide have epilepsy, and emphasize that carefully assessing and treating psychiatric disorders as part as part of standard checks in persons with epilepsy could help reduce the risk of premature death in these patients," said lead researcher Seena Fazel.
"Our study also highlights the importance of suicide and non-vehicle accidents as major preventable causes of death in people with epilepsy."
Among the researchers' findings:
- Deaths from external causes (suicides, vehicle and non-vehicle accidents, and assaults) accounted for almost 16 percent of all deaths in people with epilepsy and were the most common causes of death not linked to the underlying disease process.
- Of these, 75 percent of patients also had a diagnosis of mental disorder, with substance misuse (56 percent) and depression (23 percent) the largest contributors.
- People with both epilepsy and substance misuse were 22 times more likely to die from external causes than those with neither condition.
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