December 7, 2018

Childhood Seizures and Risk of Psychiatric Disorders in Adolescence and Early Adulthood: a Danish Nationwide Cohort Study

Pediatric seizures have been linked to psychiatric disorders in childhood, but there is a paucity of large-scale population-based studies of psychiatric comorbidity in later life. This study aimed to examine the relation between childhood seizures and the risk of psychiatric disorders in adolescence and early adulthood.

Between Jan 1, 1978, and Dec 31, 2002, 1,291,679 individuals were born in Denmark and followed up in the population cohort (approximately 15 million person-years). 43,148 individuals had a history of febrile seizures, 10,355 had epilepsy, and 1,696 had both these disorders.

83,735 (6%) cohort members were identified with at least one of the psychiatric disorders of interest. The risk of any psychiatric disorder was raised in individuals with a history of febrile seizures (hazard ratio [HR] 1·12, 95% CI 1·08–1·17), epilepsy (1·34, 1·25–1·44), or both disorders (1·50, 1·28–1·75). Excess risk of psychiatric illness associated with childhood seizures was present across a range of different disorders, most notably schizophrenia but also anxiety and mood disorders. Associations did not differ between males and females (p=0·30) but increased with a growing number of admissions for febrile seizures (p<0·0001) and with later onset of childhood epilepsy (p<0·0001).

Children with epilepsy and febrile seizures—with and without concomitant epilepsy—are at increased risk of developing a broad range of psychiatric disorders in later life. Clarification of the underlying mechanisms attributable to these associations is needed to identify potential options for prevention.

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