Abstracts

Rationale: Epilepsy is a debilitating neurological condition that affects almost 3 million Americans. Epilepsy patients are more likely to have poor health outcomes such as frequent hospitalizations, physical disability, and premature mortality. Prevalence of mental illness is also disproportionately high. However, the actual statistics of the frequency of psychiatric comorbidities are variable. Furthermore, mental illness often is often underdiagnosed and undertreated in epilepsy patients. There is a need to not both clarify the prevalence of psychiatric comorbidities as well as understand the clinical factors that may predict or mediate the presentation of mental illness. Improving our understanding of the relationship between mental illness and epilepsy is important because it can help reveal the underlying pathophysiology of the comorbidity and guide clinical care. Methods: A systematic literature review was completed to identify original research articles that performed psychiatric evaluations of adults with epilepsy. Ovid, PubMed, Cochrane, and PsychInfo databases we used and two principal investigator individually screened the articles and any conflicts were resolved by the third principal investigator. Studies were limited to original research articles and reviews were excluded. This resulted in 37 publications. The primary outcome investigated was the prevalence of psychiatric comorbidities as a percentage of the total number of the studied patients with epilepsy. Prevalence data of different psychiatric comorbidities such as depression, anxiety, and psychosis was extracted. This data was also correlated with other factors such as the length of epilepsy diagnosis, method of diagnosis, and type of epilepsy. Results: Compared to general public, patients with epilepsy were found to have increased frequency of multiple psychiatric conditions. Depression and anxiety were the most common comorbidies reported with 26.4% and 24.6%, respectively. A significant proportion of patients had social phobia (8%) and agoraphobia (8.8%). Prevalence of post-traumatic stress disorder (5.2%), schizophrenia (2.9%) and bipolar disorder (1.7%) were much lower. Rate of suicidal thoughts were 24.9% and suicidal attempts 12.3%. Conclusions: Compared to general public, patients with epilepsy were found to have increased frequency of multiple psychiatric conditions. Depression and anxiety were the most common comorbidies reported with 26.4% and 24.6%, respectively. A significant proportion of patients had social phobia (8%) and agoraphobia (8.8%). Prevalence of post-traumatic stress disorder (5.2%), schizophrenia (2.9%) and bipolar disorder (1.7%) were much lower. Rate of suicidal thoughts were 24.9% and suicidal attempts 12.3%. Funding: No funding