Epilepsy and other seizure disorders in acute psychiatric inpatients

Erlend Iversen Nakken, Frithjof Grinde, Arne Vaaler, Ole Kristian Drange, Eylert Brodtkorb, Sverre Georg Sæther, Erlend Iversen Nakken, Frithjof Grinde, Arne Vaaler, Ole Kristian Drange, Eylert Brodtkorb, Sverre Georg Sæther

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Trials registration: ClinicalTrials.gov identifier NCT01415323 .

Keywords: Acute psychiatric disorders; Acute psychiatry; Epilepsy; Prevalence; Seizures.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Flow-chart of seizure disorders in 380 patients admitted to acute psychiatric care. aThree patients had combined epilepsy + acute symptomatic seizures; 2 had epilepsy + psychogenic non-epileptic seizures + acute symptomatic seizures (Fig. 2). bFifty one patients reporting to ever having had epilepsy or seizures had no evidence of seizure disorders in their medical records
Fig. 2
Fig. 2
Venn diagram illustrating the distribution and overlap of seizure disorders in acute psychiatric inpatients

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