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