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Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
Published on: December 6, 2016
Mortalidad prematura en la epilepsia y el papel de la comorbilidad psiquiátrica: un estudio de población total
Seena Fazel1, Achim Wolf, Niklas Långström
1University of Oxford, Department of Psychiatry, Warneford Hospital, Warneford Lane, Headington, Oxford, UK.
Lancet (London, England)
|July 26, 2013
Resumen
La comorbilidad psiquiátrica aumenta significativamente el riesgo de mortalidad prematura en pacientes con epilepsia, particularmente por causas externas como el suicidio y los accidentes. Abordar la salud mental es crucial para mejorar la atención de la epilepsia y reducir las muertes prevenibles.
Área de la Ciencia:
- Neurología Neurología.
- La psiquiatría es la psiquiatría.
- Salud Pública La salud pública.
Sus antecedentes:
- La epilepsia está relacionada con mayores tasas de mortalidad prematura, pero el papel de las afecciones psiquiátricas sigue sin estar claro.
- Las causas externas como el suicidio, los accidentes y las agresiones contribuyen significativamente a esta mortalidad.
- Comprender la interacción entre la epilepsia, la comorbilidad psiquiátrica y la mortalidad es vital para un manejo eficaz.
Objetivo del estudio:
- Evaluar la prevalencia y los riesgos de mortalidad prematura por causas externas en personas con epilepsia.
- Investigar el impacto de la comorbilidad psiquiátrica en estos riesgos de mortalidad.
- Para comparar los riesgos de mortalidad en pacientes con epilepsia con controles de la población general y hermanos no afectados.
Principales métodos:
- Un estudio de cohorte a nivel nacional en Suecia (1954-2009) incluyó a 69.995 personas con epilepsia.
- Comparación con 660.869 controles de la población general y 81.396 hermanos no afectados.
- Los análisis de sensibilidad examinaron variaciones por sexo, edad, tipo de convulsión, comorbilidad psiquiátrica y tiempo transcurrido desde el diagnóstico.
Principales resultados:
- Los pacientes con epilepsia se enfrentaron a un aumento de 11.1 veces en las probabilidades de mortalidad prematura en comparación con los controles.
- Las causas externas representaron el 15,8% de las muertes, con altas probabilidades de accidentes no vehiculares (aOR 5,5) y suicidio (aOR 3,7).
- Los trastornos psiquiátricos comórbidos, especialmente la depresión y el abuso de sustancias, se asociaron fuertemente con la mortalidad por causas externas en la epilepsia.
Conclusiones:
- La reducción de la mortalidad prematura por causas externas es una prioridad en el manejo de la epilepsia.
- La comorbilidad psiquiátrica es un factor significativo en la mortalidad prematura relacionada con la epilepsia.
- Los servicios de salud y las estrategias de salud pública necesitan evaluación para prevenir estas muertes.
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