Comorbidity Trajectory in Childhood Onset Epilepsy: A 15-Year Follow-Up
Abstract number :
2.473
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2023
Submission ID :
1361
Source :
www.aesnet.org
Presentation date :
12/3/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Rachel Friefeld Kesselmayer, MS – University of Wisconsin-Madison
Susan Smedema, PhD – University of Wisconsin-Smedema; Dace Almane, MS – University of Wisconsin-Madison; Malachy Bishop, PhD – University of Wisconsin-Madison; Brian Phillips, PhD – Utah State University; Bruce Hermann, PhD – University of Wisconsin-Madison; Jana Jones, PhD – University of Wisconsin-Madison
Rationale: The purpose of this study was to describe the trajectory of psychiatric and somatic comorbidity in individuals with childhood onset epilepsy at baseline and 15 years post-epilepsy diagnosis.
Methods: Children with uncomplicated childhood onset epilepsy (age 8-18) (i.e., without intellectual disability or neurological impairment) were evaluated at baseline within 12 months of epilepsy diagnosis and 15 years later. At baseline, the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) was completed to assess current and lifetime psychiatric diagnoses consistent with the DSM-IV. At 15-year follow-up participants (now age 22-34), participated in a psychiatric interview using the Mini International Neuropsychiatric Interview (MINI). Medical comorbidity data at baseline were collected via interview and via online survey 15 years later. McNemar tests and binomial logistic regression compared persons with epilepsy to controls at baseline and follow-up.
Results: A total of 74 individuals, 30 with epilepsy and 44 healthy controls participated in both baseline and 15 year follow-up evaluations. Focal or generalized epilepsy was diagnosed in 52% and 48% of participants, respectively. At initial evaluation 70% of children with epilepsy presented with any lifetime psychiatric or somatic comorbidity; 57% with psychiatric only; 3% with somatic only; and 1% with both. Among healthy controls 39% presented with any lifetime psychiatric or somatic comorbidity; 34% with psychiatric only; 2% with somatic only; and 2% with both. A diagnosis of epilepsy served as a risk factor for any current psychiatric or somatic comorbidity (odds ratio [OR] = 3.71; 95% CI: 1.38-9.96) and any psychiatric comorbidity (odds ratio [OR] = 3.50; 95% CI: 1.32-9.29) at baseline. At follow-up, any lifetime psychiatric or somatic comorbidity was present among 90% of individuals with epilepsy; 39% psychiatric only; 11% somatic only; and 44% both. Among healthy controls, 73% had any lifetime psychiatric or somatic comorbidity; 29% psychiatric only; 7% somatic only; and 35% both. While epilepsy was no longer a significant predictor of comorbidity at follow-up, significant increases in rates of comorbidity within groups between time points were identified. Tables 1 and 2 depict specific rates of psychiatric and somatic comorbidity.
Conclusions: Comparing individuals with childhood onset epilepsy to controls at baseline and 15 year follow-up, results from this study implicate the importance of early identification and treatment of comorbidity at time of epilepsy diagnosis. As psychiatric and somatic rates of comorbidity persist and increase, continued monitoring and treatment remains a priority 15 years later. Further investigation is warranted to determine factors associated with increased rates of psychiatric and somatic comorbidity 15 years post-epilepsy diagnosis.
Funding: 2R56NS044351
Cormorbidity (Somatic and Psychiatric)