Epilepsy and other seizure disorders in acute psychiatric inpatients
Erlend Iversen NakkenFrithjof GrindeArne E. VaalerOle Kristian DrangeEylert BrodtkorbSverre Georg Sæther
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Abstract:
It is well known that patients with epilepsy have a high rate of psychiatric comorbidity. However, studies exploring epilepsy in psychiatric cohorts are scarce. The aim of this study was to examine the prevalence of seizure disorders in acute psychiatric inpatients.This is a cross-sectional study performed in a catchment-area based acute psychiatric department. All patients (age > 18) admitted during September 2011 - March 2012 were eligible for inclusion. Consenting patients were screened for a life-time history of epilepsy or seizures using self-reported questionnaire data and diagnostic codes for epilepsy in hospital and National registries. Patients scoring positive to one or more of these screening criteria underwent a thorough diagnostic validation (chart review), and the seizure disorders were classified as epilepsy, acute symptomatic seizures and/or psychogenic non-epileptic seizures according to current definitions.A total of 380 out of 591 (64.3%) consecutively admitted patients consented to participate in the study. Eighty-nine patients (23.4%) scored positive to one or more screening criteria. Fifteen (3.9%) were classified with epilepsy, 21 (5.5%) with acute symptomatic seizures and 9 (2.4%) with psychogenic non-epileptic seizures.This is the first study to report on the prevalence of seizure disorders in acute psychiatric inpatients. The life-time prevalence of epilepsy in this cohort of patients is five - six times as high as reports in the general population. These findings underscore the need for the clinical psychiatrist to have comprehensive knowledge on the interface between epileptology and psychiatry.ClinicalTrials.gov identifier NCT01415323 .Keywords:
Seizure Disorders
Psychiatric disorders in mothers and fathers increase children's risks for psychiatric problems in childhood and adulthood. The chronicity and the impact of the disorder on the parent's interactional and functional capacities are more important than the diagnosis itself. Children's psychiatric disorders are more severe and chronic and they start at an earlier age than in families with parents without psychiatric disorders. Behavioral and anxiety disorders emerge in early childhood and school age, while depression and alcohol and drug abuse in adolescence. Children's needs for prevention and treatment are to be taken care of when their parents use psychiatric services.
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INTRODUCTION
Insomnia and psychiatric disorders frequently occur together. Epidemiological studies have
demonstrated that between approximately 25% and 50% of individuals with insomnia in the
general population meet criteria for insomnia comorbid with a psychiatric disorder, including
most commonly the psychiatric comorbidities of depressive disorders, anxiety disorders, and
substance use disorders (1-3). Sleep difficulties are a common symptom of many psychiatric
disorders and in some cases treatment of the psychiatric disorder may lead to improvement or
resolution of the sleep difficulties. However, insomnia commonly persists despite treatment of
the psychiatric illness (e.g., Ref. 4) and can cause significant distress to the patient as well as an
adverse impact on the course of the psychiatric disorder.
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Aim: The aim of this study was to evaluate psychiatric morbidity risks in first-degree relatives of patients with drug dependence with and without comorbid psychiatric disorder. Methods: The case-control study was carried out in Nigeria. The Family History Method was used to evaluate psychiatric disorders in the first-degree relatives of the patients. Results: The family psychiatric morbidity risks did not predict the development of comorbid psychiatric disorder among the probands. However, psychiatric disorder in the probands correlated significantly with cannabis use, more so with early age at onset of its use. Conclusions: Familial psychiatric morbidity risk was not associated with psychiatric disorder in patients with drug dependence.
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