The following is a summary of “Multipsychiatric Comorbidity in People With Epilepsy Compared With People Without Epilepsy: A Systematic Review and Meta-analysis,” published in the July 2024 issue of Neurology by Kwon et al.

Psychiatric disorders are more common in persons with epilepsy (PwE) than in the general population, but the prevalence of multiple psychiatric conditions in this group is poorly understood.

Researchers conducted a retrospective study to summarize the prevalence of multiple psychiatric comorbidities in PwE compared to those without.

They conducted a systematic review of multipsychiatric comorbidities in PwE compared to persons without epilepsy, using the Preferred Reporting Items of Systematic Reviews and Meta-analyses reporting standards. The search spanned from January 1945 to June 2023 in Ovid MEDLINE, Embase, and PsycINFO, with terms related to “epilepsy,” “psychiatric comorbidity,” and “multimorbidity” combined with psychiatric disorders. Abstracts were reviewed in duplicate, and data were independently extracted using a standard proforma. Data on multipsychiatric comorbidities in PwE vs. persons without epilepsy were recorded. Descriptive statistics and, when possible, meta-analyses were presented. The risk of bias was assessed using the Newcastle-Ottawa Scale and the International League Against Epilepsy tool.

The results showed that 12,841 records and 15 studies met the eligibility criteria. All included studies were high-quality and had a risk of bias. The prevalence of multipsychiatric comorbidity was higher in PwE compared to those without. In 2 population-based studies, the pooled prevalence of concomitant depression and anxiety disorder in PwE was 15 of 163 (9.2%), significantly higher than 250 of 10,551 (2.4%) in patients without epilepsy (OR 3.7, 95% CI 2.1–6.5, P<0.001, I² = 0%, Cochran Q P-value for heterogeneity = 0.84). In 2 hospital-based studies, the prevalence of concomitant depression and attention-deficit/hyperactivity disorder in PwE was 14 of 97 (14.4%), significantly higher than 5 of 126 (3.9%) in patients without epilepsy (OR 5.2, 95% CI 1.8–15.0, P=0.002, I²= 0%, Cochran Q P-value for heterogeneity = 0.79).

Investigators concluded that PwE had higher rates of multiple psychiatric comorbidities compared to those without, but further research is needed to fully understand the extent, impact, and prognostic implications of these comorbidities.

Source: neurology.org/doi/10.1212/WNL.0000000000209622