Substance use disorders and psychotic disorders in epilepsy: a population-based registry study

Inger Johanne Bakken; Eline Revdal; Ragnar Nesvåg; Eiliv Brenner; Gun Peggy Knudsen; Pål Surén; Sara Ghaderi; Nina Gunnes; Per Magnus; Ted Reichborn-Kjennerud; Camilla Stoltenberg; Lill Iren Trogstad; Siri Eldevik Håberg; Eylert Brodtkorb

doi:10.1016/j.eplepsyres.2014.06.021

Substance use disorders and psychotic disorders in epilepsy: a population-based registry study

Epilepsy Res. 2014 Oct;108(8):1435-43. doi: 10.1016/j.eplepsyres.2014.06.021. Epub 2014 Jul 7.

Authors

Affiliations

¹ Norwegian Institute of Public Health, Oslo, Norway. Electronic address: inger.johanne.bakken@fhi.no.
² Department of Neurology and Clinical Neurophysiology, St. Olav Hospital, Trondheim, Norway. Electronic address: eline.revdal2@stolav.no.
³ Norwegian Institute of Public Health, Oslo, Norway. Electronic address: ragnar.nesvag@fhi.no.
⁴ Department of Neurology and Clinical Neurophysiology, St. Olav Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: eiliv.brenner@ntnu.no.
⁵ Norwegian Institute of Public Health, Oslo, Norway. Electronic address: gunpeggy.knudsen@fhi.no.
⁶ Norwegian Institute of Public Health, Oslo, Norway. Electronic address: pal.suren@fhi.no.
⁷ Norwegian Institute of Public Health, Oslo, Norway. Electronic address: sara.ghaderi@fhi.no.
⁸ Norwegian Institute of Public Health, Oslo, Norway. Electronic address: nina.gunnes@fhi.no.
⁹ Norwegian Institute of Public Health, Oslo, Norway. Electronic address: per.magnus@fhi.no.
¹⁰ Norwegian Institute of Public Health, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: ted.reichborn-kjennerud@fhi.no.
¹¹ Norwegian Institute of Public Health, Oslo, Norway; Department of Global Public Health and Primary Care, University of Bergen, Norway. Electronic address: camilla.stoltenberg@fhi.no.
¹² Norwegian Institute of Public Health, Oslo, Norway. Electronic address: lill.iren.trogstad@fhi.no.
¹³ Norwegian Institute of Public Health, Oslo, Norway. Electronic address: sirieldevik.haberg@fhi.no.
¹⁴ Department of Neurology and Clinical Neurophysiology, St. Olav Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: eylert.brodtkorb@ntnu.no.

PMID: 25062893
DOI: 10.1016/j.eplepsyres.2014.06.021

Abstract

Background: Epilepsy affects around 70 million people worldwide. Psychiatric comorbidity may add to the burden of the disease. We studied substance use disorders and psychotic disorders among people with epilepsy from a population-based perspective.

Methods: Norwegian specialist health services (hospitals and outpatient clinics) report diagnoses for individual patients to the Norwegian Patient Register. We used information on subjects born in 1930-1994 who were registered with a diagnosis of epilepsy at least once during the five-year period of 2008-2012. We compared the proportion of people with epilepsy registered with substance use disorders (alcohol use disorders or non-alcohol drug use disorders) and psychotic disorders (schizophrenia spectrum disorders or bipolar disorder) with similar figures in the population without epilepsy. We applied chi-square tests and log-binomial regression for analysis.

Results: Overall, 0.90% of the Norwegian adult population was registered with epilepsy in somatic hospitals during 2008-2012. The total proportion registered with alcohol use disorder was 5.74% among people with epilepsy and 1.29% in the population without epilepsy (age- and sex-adjusted relative risk [RR]: 4.42, 95% confidence interval [CI]: 4.22-4.62). The corresponding figures were 4.32% and 1.22% (RR 3.86 [95% CI: 3.67-4.06] for drug use disorder, 1.72% and 0.60% (RR 2.94 [95% CI: 2.71-3.19]) for schizophrenia spectrum disorders, and 1.50% and 0.68% (RR 2.29 [95% CI: 2.10-2.49]) for bipolar disorder.

Conclusion: People with epilepsy were more often registered with substance use disorders and psychotic disorders than people without epilepsy. Psychiatric comorbidity requires particular attention in both diagnostic work-up and management of epilepsy, and creates complex medical challenges that require close cooperation between neurologists and psychiatrists. These findings may have implications for the organization and further development of comprehensive epilepsy care.

Keywords: Epidemiology; Epilepsy; Psychiatric comorbidity; Psychotic disorders; Substance use disorders.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Epilepsy / diagnosis
Epilepsy / epidemiology*
Female
Humans
Male
Middle Aged
Norway / epidemiology
Population Surveillance* / methods
Psychotic Disorders / diagnosis
Psychotic Disorders / epidemiology*
Registries*
Substance-Related Disorders / diagnosis
Substance-Related Disorders / epidemiology*
Young Adult