Psychiatric and behavioral comorbidity among young adults with childhood-onset epilepsy. A long-term population study
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Julkaisu on tekijänoikeussäännösten alainen. Teosta voi lukea ja tulostaa henkilökohtaista käyttöä varten. Käyttö kaupallisiin tarkoituksiin on kielletty.
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Aim: To investigate the incidence of psychiatric and behavioral comorbidity in young adults with childhood-onset epilepsy.
Hypotheses: We hypothesized that 1) comorbidity is a common feature in childhood-onset epilepsy, and following this, that 2) psychiatric comorbidity is more common than other comorbidity.
Subjects and methods: A population-based cohort of 150 children, whose first visit for evaluation of seizures and diagnosis for active epilepsy occurred between January 1961 and December 1964. The original medical charts and following check-up notes of the subjects were reviewed for any comorbid diagnoses coded (according to ICD-10) from epilepsy onset to the end of follow-up on December 31, 1991.
Results: At the end of follow-up that lasted for a mean of 27.7 years, 134 subjects were still alive and 16 had died. 81% of children with epilepsy exhibited at least one comorbid psychiatric disorder by age 32. Nearly half had childhood behavioral or emotional disorders (incidence 67.6/100000), fol-lowed by intellectual disability (incidence 57.4/100000) and disorders of psychological development. Neurotic and mood disorders were significantly more common in females, while intellectual disability was significantly more common in males. Generalized seizures other than absence seizures or general-ized tonic-clonic seizures were the only seizure type significantly associated with higher psychiatric comorbidity. Non-psychiatric comorbidities were found in 86 % of subjects.
Discussion: The occurrence of psychiatric and behavioral disorders in our study exceeds that of pre-vious studies (ranging from 37%–77%), which is, at least in part, based on our very long-term follow-up period that also accounts for the transfer from pediatric to adult healthcare, a period of vulnerability to psychopathology. Our other findings, including the most marked comorbid disorders and the fe-male/male predominance for the prevalence of specific disorders, largely follow what has been pre-sented in literature.
Conclusions: With long-term follow-up, psychiatric and behavioral comorbidity is shown to affect the vast majority of patients with childhood-onset epilepsy.