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. 2021 May 3;7(3):e95.
doi: 10.1192/bjo.2021.55.

Association between epilepsy and psychiatric disorders in adults with intellectual disabilities: systematic review and meta-analysis

Basma Akrout Brizard  1 , Bharati Limbu  2 , Carolina Baeza-Velasco  3 , Shoumitro Deb  4
Affiliations

Association between epilepsy and psychiatric disorders in adults with intellectual disabilities: systematic review and meta-analysis

Basma Akrout Brizard et al. BJPsych Open. .

Abstract

Background: Psychiatric disorders, such as depression and anxiety, are commonly associated with epilepsy in the general population, but the relationship between psychiatric disorders and epilepsy among adults with intellectual disabilities is unclear.

Aims: To conduct a systematic review and meta-analysis to assess whether epilepsy is associated with an increased rate of psychiatric disorders in adults with intellectual disabilities.

Method: We included literature published between 1985 and 2020 from four databases, and hand-searched six relevant journals. We assessed risk of bias by using SIGN 50 and the Cochrane risk of bias tool. Several meta-analyses were carried out.

Results: We included 29 papers involving data on 9594 adults with intellectual disabilities, 3180 of whom had epilepsy and 6414 did not. Of the 11 controlled studies that compared the overall rate of psychiatric disorders between the epilepsy and non-epilepsy groups, seven did not show any significant inter-group difference. Meta-analysis was possible on pooled data from seven controlled studies, which did not show any significant inter-group difference in the overall rate of psychiatric disorders. The rates of psychotic disorders, depressive disorders and anxiety disorders were significantly higher in the non-epilepsy control groups compared with the epilepsy group, with effect sizes of 0.29, 0.47 and 0.58, respectively. Epilepsy-related factors did not show any definite association with psychiatric disorders.

Conclusions: It is difficult to pool data from such heterogeneous studies and draw any definitive conclusion because most studies lacked an appropriately matched control group, which will be required for future studies.

Keywords: Intellectual disabilities; epilepsy; meta-analysis; psychiatric disorders; systematic review.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Review and Meta-Analysis flow chart of the study selection process.
Fig. 2
Fig. 2
Forest plot of eight studies on overall psychiatric disorders before sensitivity analysis. M-H: Mantel-Haenszel method; EP: Epilepsy.
Fig. 3
Fig. 3
Forest plot of data from seven studies on overall psychiatric disorders after sensitivity analysis. M-H: Mantel-Haenszel method; EP: Epilepsy.
Fig. 4
Fig. 4
Forest plot of data from five studies on psychotic disorders. M-H: Mantel-Haenszel method; EP: Epilepsy.
Fig. 5
Fig. 5
Forest plot of data from four studies on depressive disorders. M-H: Mantel-Haenszel method; EP: Epilepsy.
Fig. 6
Fig. 6
Forest plot of data from five studies on anxiety disorders. M-H: Mantel-Haenszel method; EP: Epilepsy.
Fig. 7
Fig. 7
Cochrane risk of bias summary figure for 25 controlled studies. Red with minus sign = high risk of bias; Yellow with exclamation point = unknown risk of biais; Green with plus sign = low risk of bias
See this image and copyright information in PMC

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