HOUSTON — It is not uncommon for epilepsy patients to also have psychiatric conditions, according to a new study which used VHA records to better understand the co-morbidity.
The articles in Epilepsy & Behavior noted that “studies examining veterans with epilepsy suggest this population may present with unique psychiatric and clinical features. Drug-resistant epilepsy (DRE) may confer a greater risk of psychiatric dysfunction; however, there is a paucity of literature documenting this.”1
The Baylor College of Medicine-led researchers assessed a comprehensive VHA-wide sample, describing psychiatric conditions, medications and healthcare utilization, to elucidate the link between DRE and psychiatric dysfunction. Also involved in the research were VAMCs in Durham, NC; Richmond, VA; and Houston.
The study team collected data on psychiatric and hospitalization data on 52,579 veterans enrolled in VHA healthcare between fiscal year 2014 and the second quarter of FY 2020 from the agency’s Corporate Data Warehouse administrative data. The focus was on psychiatric diagnosis, psychotropic medication use and utilization of hospital services.
The study determined that at least one psychiatric diagnosis was present in 70.2% of patients, while 49.8% had two or more diagnoses. The most common psychiatric co-morbidities were depression (51.7%), post-traumatic stress disorder (PTSD) (38.8%) and anxiety (38.0%).
“Psychiatric medication use was present in 73.3%”, the authors advised. “Emergency room (ER) visits were highest in those with suicidality (mean 14.9 visits), followed by bipolar disorder (10.3), and schizophrenia (12.1). Psychiatric-related hospitalizations were highest for schizophrenia (mean 2.5 admissions) and bipolar disorder (2.3). Females had more psychiatric diagnoses (2.4 vs. 1.6, p < 0.001), psychiatric medications (3.4 vs. 2.3, p < 0.001), and ER utilization than males (6.9 vs. 5.5, p < 0.001).”
The researchers pointed out that a “substantial psychiatric burden exists among veterans with DRE. Compared to prior epilepsy literature, results suggest that veterans with DRE evidence more prevalent psychiatric comorbidity, emergency care usage, and inpatient psychiatric admissions. Females were especially impacted, with greater rates of psychiatric conditions and treatment.”
The authors added, “Considering the relationship of psychiatric comorbidities in epilepsy with psychosocial functioning and quality of life, our findings highlight the need for screening and provision of services for those with DRE.”
- Sullivan-Baca E, Rehman R, Towne AR, Haneef Z. Psychiatric co-morbidity of drug-resistant epilepsy in Veterans. Epilepsy Behav. 2022 Dec 26;139:109059. doi: 10.1016/j.yebeh.2022.109059. Epub ahead of print. PMID: 36577335.
