Psychiatric Comorbidities and Healthcare Utilization increase 5 years prior in Idiopathic Generalized Epilepsy: Study

Idiopathic Generalized Epilepsies
are associated with specific behavioral characteristics, frontal lobe
dysfunction, and coexisting psychiatric conditions. There is ambiguity as to
whether the psychiatric symptoms are part of the disease or are secondary to
the burden of the disease. Hence, researchers from Denmark conducted a study to
identify and explore the timeline of psychiatric and epilepsy symptoms in
patients with IGE.

A register-based case-control
study included individuals aged 10-25 with an IGE diagnosis. Two distinct
cohorts were established. One cohort was identified through Danish health
registers. This cohort included IGE identified through ICD 10 and first-time
diagnoses of IGE between 2005 and 2018. The other cohort included patients treated
at Odense University Hospital and the Danish Epilepsy Centre in the same
period. Each patient was matched with 10 matched controls from the normal
population controls of the Danish registers. These included individuals
matched to age, sex, and geography. The social status, health care utilization,
and psychiatric diagnoses of the individuals between the two age groups were compared.
This comparison was observed for at least 5 years before the epilepsy diagnosis,
during the diagnosis, and at the end of the study period. Wilcoxon rank sum
test and confirmatory logistic regression models were used for the statistical
analysis.

Findings:

• About 1,009 patients were identified for the
  register-based cohort. Among them, 55.1% were female, with a mean age at
  diagnosis [SD]: 15.9 [±3.8] years, and were matched with 10.090 controls.
• The hospital-based cohort included about 402
  patients. Of them, 56.2% were female, with a mean age at diagnosis [SD] of 18.3
  [±7.4] years. They were matched to 4020 controls.
• IGE cohorts and controls did not differ at
  birth.
• About 5 years before the IGE diagnosis, registered
  patients had more hospital visits and increased visits to their general
  practitioners. Also, they received more prescriptions for psychiatric
  medications compared with controls.
• Registered Patients also showed a higher rate of
  psychiatric comorbidity at the end of the study than controls.
• Data were similar in the hospital-based cohort.

Thus, the study concluded that a
prodroma phase exists approximately 5 years before the IGE diagnosis, when
patients utilize healthcare facilities and medications more. These highlight
the importance of mental health challenges that develop before the diagnosis of
IGE. The study also stresses the importance of early monitoring and optimum
mental health care to be taken for individuals with epilepsy.

Further reading: Gesche J,
Rubboli G, Beier CP. Prodromal Phase of Idiopathic Generalized Epilepsy: A
Register-Based Case Control Study. Neurology. 2024;103(8):e209921.
doi:10.1212/WNL.0000000000209921