Post-Traumatic Stress-Disorder in Epilepsy: Meta-analysis of current evidence

• Published in: Epilepsy & behavior 2024-08, Vol.157, p.109833, Article 109833
• Main Authors: Pepi, Chiara, Mercier, Mattia, Salimbene, Licia, Galati, Cristina, Specchio, Nicola, de Palma, Luca
• Format: Article
• Language: English
• Subjects: Comorbidity; Epilepsy; Epilepsy - complications; Epilepsy - epidemiology; Epilepsy - psychology; Humans; Meta-analysis; Post-traumatic stress disorder; Prevalence; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - psychology
• ISSN: 1525-5050; 1525-5069; 1525-5069
• DOI: 10.1016/j.yebeh.2024.109833

•20–30% of patients with epilepsy have psychiatric comorbidities.•Fifteen studies, comprising 996 patients, are included in this metanalysis.•The overall pooled prevalence of PTSD in epilepsy patients was 18%.•There is a three-fold increased risk of PTSD in epilepsy versus general population.•Prevalence of PTSD in uncontrolled vs controlled studies is 25% vs 14%. Epilepsy, a chronic neurological condition characterized by unpredictable seizures, poses considerable challenges, including disability, stigma, and increased mortality. Psychiatric comorbidities are prevalent in 20–30% of epilepsy patients, notably mood or anxiety disorders, psychotic symptoms, and personality disorders. Trauma and childhood adversities are pivotal risk factors for psychopathology, yet the link between Post-Traumatic Stress Disorder (PTSD) and epilepsy remains underexplored. This meta-analysis is aimed to establish updated estimates of PTSD prevalence among individuals with epilepsy. Fifteen studies, comprising 996 epilepsy patients, were included. The overall pooled prevalence of PTSD in epilepsy patients was 18%. Notably, patients with epilepsy exhibited a three-fold increased risk of developing PTSD compared to the general population. Subgroup analysis revealed a higher PTSD prevalence in uncontrolled studies (25%) compared to controlled studies (14%). Additionally, patients with Psychogenic Non-Epileptic Seizures (PNES) demonstrated higher PTSD prevalence than epilepsy patients, with a threefold higher risk in healthy controls compared to PNES controls. While gender prevalence did not significantly affect PTSD occurrence, drug resistant epilepsy did not correlate with PTSD prevalence. Moreover, age of epilepsy onset showed no significant correlation with PTSD prevalence. This meta-analysis underscores the substantial burden of PTSD among epilepsy patients, potentially attributable to the traumatic nature of seizures and the chronic stigma associated with epilepsy. Improved recognition and management of psychiatric conditions, particularly PTSD, are crucial in epilepsy care pathways to enhance patients' quality of life. Further research and comprehensive diagnostic tools are imperative to better understand and address the prevalence of PTSD in epilepsy patients.