Summary: One in four people who have both schizophrenia and epilepsy die between the ages of 25-50.
Source: Aarhus University
Patients who suffer from schizophrenia and epilepsy are particularly vulnerable. In the study, the researchers followed more than 1,5 million people and classified them according to whether they were diagnosed with epilepsy, schizophrenia or the combination of epilepsy and schizophrenia on their twenty-fifth birthday.
“There was an exceedingly high mortality rate among people with these disorders, particularly those who suffer from the combination of epilepsy and schizophrenia. More than 25 per cent of them die between the ages of 25-50,” says Jakob Christensen, who is one of the researchers behind the study.
He is a clinical associate professor and DMSc at the Department of Clinical Medicine at Aarhus University and consultant at the Department of Neurology at Aarhus University Hospital. He is also a member of the national psychiatric project iPSYCH and the epilepsy project EpiPsych which carries out research into the correlation between epilepsy and mental disorders.
Patients fall between two chairs
The researchers hope to see the results raise awareness about the difficulties of living with epilepsy and schizophrenia.
“The results are really intended to help healthcare professionals develop new working processes so that this group of patients can get the right treatment. We already know from previous studies, that this group of patients die from a wide range of lifestyle diseases, and that some of these are preventable,” says Jakob Christensen and continues:
“With the way things are now, this patient group can easily fall between two chairs and end up being sent back and forth between different medical specialists or between hospitals and their general practitioner. It appears that people with epilepsy and schizophrenia are particularly vulnerable – and there is certainly room for improvement in the way the healthcare system deals with them and their treatment.”
Studies have identified a clear association between epilepsy and mental disorders, including depression, anxiety, schizophrenia and psychosis. A Danish study has e.g. shown that people with epilepsy have a risk of developing schizophrenia that is two-and-a-half times higher than those without epilepsy.
Among the subjects in the study, 18,943 were diagnosed with epilepsy, 10,208 were diagnosed with schizophrenia, and 471 were diagnosed with both epilepsy and schizophrenia before they turned twenty-five. The mortality rate for these subjects at age fifty was 3.1 per cent for people who did not suffer from epilepsy and schizophrenia; 10.7 per cent for people with epilepsy; 17.4 per cent for people with schizophrenia; and 27.2 per cent for people with both epilepsy and schizophrenia.
Background for the results:
The study is a population-based nationwide cohort study of people born in Denmark between 1960-87 who were resident in Denmark on their twenty-fifth birthday.
Funding: The study has received financing from the Lundbeck Foundation, the Novo Nordisk Foundation, Aarhus University and the Central Denmark Region.
Conflicts of interest: Jakob Christensen has received remuneration for acting as a scientific adviser to UCB Nordic and Eisai AB, and speaking fees from UCB Nordic and Eisai AB for lectures, as well as financing for travel from UCB Nordic. Jakob Christensen is also involved in other studies involving the companies: Pfizer, Novartis, Eisai AB and Sage Therapeutics. Inc.
Premature mortality in persons with epilepsy and schizophrenia: A population‐based nationwide cohort study
Objective To determine the mortality for persons with epilepsy and schizophrenia by absolute and relative measures.
Methods This is a population‐based nationwide cohort study of persons born in Denmark from 1960 to 1987 who were alive and residing in Denmark on their 25th birthday. We identified persons diagnosed with epilepsy and schizophrenia prior to their 25th birthday and followed them to death, emigration, or December 31, 2012, whichever came first. The primary outcome was overall mortality. Data were analyzed using Cox regressions.
Results Persons were followed for 24 167 573 person-years; the median was 15 years. The mortality rate ratio was 4.4 (95% confidence interval [CI] = 4.1‐4.7) for persons with epilepsy, 6.6 (95% CI = 6.1‐7.1) for persons with schizophrenia, and 12.8 (95% CI = 9.1‐18.1) for persons with both disorders, compared with persons without these disorders. The estimated cumulative mortality at the age of 50 years was 3.1% (95% CI = 3.0‐3.1) for persons without epilepsy and schizophrenia, 10.7% (95% CI = 9.7‐11.8) for persons with epilepsy, 17.4% (95% CI = 16.0‐18.8) for persons with schizophrenia, and 27.2% (95% CI = 15.7‐40.1) for persons with both disorders.
Significance Persons with epilepsy and schizophrenia have very high mortality; more than one in four persons with both disorders died between the age of 25 and 50 years, indicating that these patients need special clinical attention.