Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Jan 1;82(1):72-84.
doi: 10.1001/jamaneurol.2024.3976.

Psychiatric Comorbidities in Persons With Epilepsy Compared With Persons Without Epilepsy: A Systematic Review and Meta-Analysis

Churl-Su Kwon  1   2   3   4   5 , Ali Rafati  6 , Ruth Ottman  1   2   4   7 , Jakob Christensen  8   9 , Andres M Kanner  10 , Nathalie Jetté  11 , Charles R Newton  5
Affiliations
Meta-Analysis

Psychiatric Comorbidities in Persons With Epilepsy Compared With Persons Without Epilepsy: A Systematic Review and Meta-Analysis

Churl-Su Kwon et al. JAMA Neurol. .

Abstract

Importance: Several psychiatric disorders have been found to occur more frequently in persons with epilepsy (PWE) than in persons without epilepsy.

Objective: To summarize the prevalence of 20 psychiatric disorders in PWE compared with persons without epilepsy.

Data sources: The search included records from inception to February 2024 in Ovid, MEDLINE, Embase, and PsycINFO.

Study selection: Published epidemiological studies examining the prevalence of psychiatric disorders among PWE compared with persons without epilepsy were systematically reviewed. There were no restrictions on language or publication date.

Data extraction and synthesis: Abstracts were reviewed in duplicate, and data were extracted using a standardized electronic form. Descriptive statistics and meta-analyses are presented.

Main outcomes and measures: Data were recorded on the prevalence of 20 psychiatric disorders among PWE compared with persons without epilepsy. Meta-analyses were performed along with descriptive analyses.

Results: The systematic search identified 10 392 studies, 27 of which met eligibility criteria. The meta-analyses included 565 443 PWE and 13 434 208 persons without epilepsy. The odds of most psychiatric disorders studied were significantly increased in PWE compared with those without epilepsy, including anxiety (odds ratio [OR], 2.11; 95% CI, 1.73-2.58); depression (OR, 2.45; 95% CI, 1.94-3.09); bipolar disorder (OR, 3.12; 95% CI, 2.23-4.36); suicidal ideation (OR, 2.25; 95% CI, 1.75-2.88) but not suicide attempt (OR, 3.17; 95% CI, 0.49-20.46); psychotic disorder (OR, 3.98; 95% CI, 2.57-6.15); schizophrenia (OR, 3.72; 95% CI, 2.44-5.67); obsessive-compulsive disorder (OR, 2.71; 95% CI, 1.76-4.15); posttraumatic stress disorder (OR, 1.76; 95% CI, 1.14-2.73); eating disorders (OR, 1.87; 95% CI, 1.73-2.01); alcohol misuse (OR, 3.64; 95% CI, 2.27-5.83) and alcohol dependence (OR, 4.94; 95% CI, 3.50-6.96) but not alcohol abuse (OR, 2.10; 95% CI, 0.60-7.37); substance use disorder (OR, 2.75; 95% CI, 1.61-4.72); autism spectrum disorder (OR, 10.67; 95% CI, 6.35-17.91); and attention-deficit/hyperactivity disorder (OR, 3.93; 95% CI, 3.80-4.08).

Conclusions and relevance: In this comprehensive study, most psychiatric comorbidities examined were significantly more prevalent in PWE than in those without epilepsy. These findings show the high burden of psychiatric comorbidities in PWE. This, in turn, underscores the need for appropriately identifying and treating psychiatric comorbidity in epilepsy to manage patients effectively and improve quality of life.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Kanner reported honoraria from the Epilepsy Foundation for serving as co–editor in chief of Epilepsy.com and from Xenon Laboratories for scientific board meeting participation outside the submitted work. Dr Jetté reported grants from the National Institute of Neurological Disorders and Stroke and honoraria as an associate editor of Epilepsia outside the submitted work. No other disclosures were reported.

References

    1. Fiest KM, Dykeman J, Patten SB, et al. . Depression in epilepsy: a systematic review and meta-analysis. Neurology. 2013;80(6):590-599. doi:10.1212/WNL.0b013e31827b1ae0 - DOI - PMC - PubMed
    1. Scott AJ, Sharpe L, Hunt C, Gandy M. Anxiety and depressive disorders in people with epilepsy: a meta-analysis. Epilepsia. 2017;58(6):973-982. doi:10.1111/epi.13769 - DOI - PubMed
    1. Abraham N, Buvanaswari P, Rathakrishnan R, et al. . A meta-analysis of the rates of suicide ideation, attempts and deaths in people with epilepsy. Int J Environ Res Public Health. 2019;16(8):1451. doi:10.3390/ijerph16081451 - DOI - PMC - PubMed
    1. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264-269. doi:10.7326/0003-4819-151-4-200908180-00135 - DOI - PubMed
    1. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603-605. doi:10.1007/s10654-010-9491-z - DOI - PubMed