Identification of co-morbidities

Abstract

There is a high burden of comorbidity in people with epilepsy. Several diseases, including depression, anxiety, dementia, migraine, heart disease, peptic ulcers, and arthritis are up to eight times more common in those with epilepsy than in the population at large. The risk of premature mortality is an important part of the burden imposed on people with epilepsy and this is directly related to the presence of comorbid conditions. Several mechanisms are responsible for the association of epilepsy and comorbidities including shared risk factors and bidirectional relations. There is a pressing need for new and validated screening instruments and guidelines to help with the early detection and treatment of comorbid conditions. There is evidence that some conditions, such as depression and migraine, negatively affect outcome and quality of life. Understanding which comorbidities might develop in a given individual is, therefore, relevant. Early identification of comorbid conditions may lead to early intervention and substantial benefits in terms of health care. Psychiatric, cognitive, and somatic comorbidities are frequently unexposed and therefore, are not treated. The use of screening instruments should be encouraged although there is still a pressing need for the development and validation of such instruments for people with epilepsy with specific comorbidities. Currently, part of a comprehensive assessment of an individual with epilepsy should always include a detailed history of previous and concomitant somatic, cognitive and psychiatric health problems.