People with epilepsy are 11 times more likely to die prematurely than the general population, and the risk appears to be much higher for individuals with common co-existing psychiatric illnesses, especially depression and alcohol and drug use disorders, a new research published in the Lancet has suggested.
In the 41-year study of almost 70 000 patients with epilepsy, researchers found that three-quarters of those who died from accidents or suicide had also been diagnosed with a psychiatric condition during their lifetime.
Led by Seena Fazel from the University of Oxford, the study looked at 69 995 people with epilepsy born in Sweden between 1954 and 2009 who were tracked for up to 41 years. The causes of death were assessed and compared with 660 869 age-matched and sex-matched individuals from the general population, and 81 396 unaffected siblings of people with epilepsy to account for the influence of genetic or early environmental risk factors.
About 9 per cent (6155) of people with epilepsy died during follow up compared with 0.7 per cent (4892) of people from the general population.
Deaths from external causes included suicides, vehicle and non-vehicle accidents, and assaults that accounted for almost 16% 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 per cent of patients also had a diagnosis of mental disorder, with substance misuse (56 per cent) and depression (23 per cent) the largest contributors.
Findings revealed that people with both epilepsy and substance misuse were 22 times more likely to die from external causes than those with neither condition.
The majority of early deaths from external causes were from suicides, with the odds of death four times higher for those with epilepsy than controls. Significantly, the researchers also found that the risk of early death in people with epilepsy compared with their unaffected siblings, and the risk of early death in people with epilepsy compared with general population, did not differ significantly.