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Mortality rate high in patients with comorbid epilepsy and schizophrenia

07 Jun 2019

More than one in four patients with both epilepsy and schizophrenia die between the age of 25 and 50 years, as reported in a recent study.

The study included 1,620,376 individuals born in Denmark between 1960 and 1987 and who were alive on their 25th birthday. At the start of follow‐up, 18,943 participants were diagnosed with epilepsy, 10,208 were diagnosed with schizophrenia, and 471 were diagnosed with both conditions. The median follow‐up time was 15 years.

Overall, 25,596 (1.58 percent) participants died. The mortality rate ratio was 4.4 (95 percent CI, 4.1–4.7) for participants with epilepsy, 6.6 (6.1–7.1) for those with schizophrenia and 12.8 (9.1–18.1) for those with comorbid conditions, with participants without these disorders as the control group.

The estimated cumulative mortality at 50 years of age was alarmingly high in participants with both epilepsy and schizophrenia at 27.2 percent (15.7–40.1) relative to 3.1 percent (3.0–3.1) in controls, 10.7 percent (9.7–11.8) in those with epilepsy and 17.4 percent (16.0–18.8) in those with schizophrenia.

The present study suggests that patients with comorbid epilepsy and schizophrenia need special clinical attention, researchers said. The findings should also promote the development of strategies for early identification and timely treatment to reduce mortality in this population.

Additional research is warranted to determine whether these elevated death rates are related to the disorder, underlying aetiology, comorbid diseases or treatment.

While the causes of deaths were not explored in the current study, previous reports have shown that patients with epilepsy and those with schizophrenia have higher mortality from both natural and unnatural causes. [Neurology 2016;86:704-712; Epilepsy Res 2015;114:81-88; Arch Gen Psychiatry 2007;64:1123-1131; JAMA Psychiatry 2015;72:1172-1181]

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