Multimorbidity in adults with epilepsy attending an outpatient epilepsy clinic

Knowledge about multimorbidity and types of multiple chronic conditions (CC) in people with epilepsy (PWE) seen in an outpatient care setting is lacking. We aim to examine the distribution of multimorbidity and describe the contributing comorbidity of somatic and psychiatric CC in adult PWE in relation to age (≤25; 26-64; ≥65 years), sex (female; male), type of epilepsy (Idiopathic; Structural; Developmental & Epileptic Encephalopathy [DEE]), resistance to treatment (yes; no), and duration of epilepsy (as per 4 quartiles).

In this observational retrospective cohort study, we assessed 330 adult PWE seen in an epilepsy outpatient clinic. The prevalence of multimorbidity was estimated according to the presence of one or more somatic or psychiatric comorbid CC. We estimated the multimorbidity prevalence within each group and assessed for statistically significant differences.

Nearly 80% of PWE seen in an outpatient setting were multimorbid. Over two thirds of participants had a somatic CC and over two fifths a psychiatric CC. These conditions did not occur randomly but varied in relation to age, type of epilepsy, and resistance to treatment. Almost all older adults with epilepsy were multimorbid due to common somatic CC. Neurodevelopmental disorders were often seen in the young adults with epilepsy, people with drug-resistant epilepsy, and/or DEE. The most common chronic comorbid conditions in PWE included depression, anxiety, and insomnia. There appeared to be no influence on the prevalence of multimorbidity in epilepsy based on sex, drug resistance, or duration of epilepsy.

This is the first study of multimorbidity in adult PWE seen in an outpatient setting and its distribution according to patient and epilepsy characteristics. The findings provide insights into the burden of chronic disease in PWE seen in tertiary care and call for adequate identification and response to patient's needs by health professionals.