Comorbidity and risk of mortality in people with epilepsy

In one study, data from multiple national registries and censuses in Sweden were used to determine the presence of epilepsy and comorbidities and also cause of death.³ Pre-existing psychiatric diagnoses were recorded for 18.0% of people with epilepsy and 3.5% of controls, while new psychiatric diagnoses were recorded for 22.7% of people with epilepsy and 6.9% of controls.³ The OR of suicide for people with epilepsy and a comorbid psychiatric disorder was 14.0 compared with no epilepsy or psychiatric disorder.³ The OR for suicide was 22.9 when comparing epilepsy and comorbid depression vs no epilepsy or depression, and 21.5 when comparing epilepsy and comorbid substance misuse vs no epilepsy or substance misuse.³

References:

1.Keezer MR, Sisodiya SM, Sander JW. Comorbidities of epilepsy: current concepts and future perspectives. Lancet Neurol 2016; 15 (1): 106–115.

2.Thijs RD, Surges R, O’Brien TJ, Sander JW. Epilepsy in adults. Lancet 2019; 393 (10172): 689–701.

3.Fazel S, Wolf A, Långström N, et al. Premature mortality in epilepsy and the role of psychiatric comorbidity: a total population study. Lancet 2013; 382 (9905): 1646–1654.

4.Nashef L, So EL, Ryvlin P, Tomson T. Unifying the definitions of sudden unexpected death in epilepsy. Epilepsia 2012; 53 (2): 227–233.

5.Boglietti E, Haddad D, Bezin L, Rheims S. Pathophysiology of SUDEP: how far are we from understanding? Rev Neurol (Paris) 2025; 181 (5): 432–437.

6.Sveinsson O, Andersson T, Mattsson P, et al. Clinical risk factors in SUDEP: a nationwide population-based case-control study. Neurology 2020; 94 (4): e419–e429.