Psychiatric comorbidities in epilepsy: population co-occurrence, genetic correlations and causal effects
Background Psychiatric comorbidities are common in patients with epilepsy. Reasons for the co-occurrence of psychiatric conditions and epilepsy remain poorly understood.Aim We aimed to triangulate the relationship between epilepsy and psychiatric conditions to determine the extent and possible origi...
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| Language: | English |
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BMJ Publishing Group
2024-02-01
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| Series: | General Psychiatry |
| Online Access: | https://gpsych.bmj.com/content/37/1/e101201.full |
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| author | Neil M Davies Dheeraj Rai Harriet Forbes Christina Dalman Torbjörn Tomson Daniel Berglind Michael Lundberg Cecilia Magnusson Craig Newschaffer Brian K Lee Viktor H Ahlqvist Paul Madley-Dowd Christina Dardani Jessica Rast Caichen Zhong Renee M Gardner Kristen Lyall |
| author_facet | Neil M Davies Dheeraj Rai Harriet Forbes Christina Dalman Torbjörn Tomson Daniel Berglind Michael Lundberg Cecilia Magnusson Craig Newschaffer Brian K Lee Viktor H Ahlqvist Paul Madley-Dowd Christina Dardani Jessica Rast Caichen Zhong Renee M Gardner Kristen Lyall |
| author_sort | Neil M Davies |
| collection | DOAJ |
| description | Background Psychiatric comorbidities are common in patients with epilepsy. Reasons for the co-occurrence of psychiatric conditions and epilepsy remain poorly understood.Aim We aimed to triangulate the relationship between epilepsy and psychiatric conditions to determine the extent and possible origins of these conditions.Methods Using nationwide Swedish health registries, we quantified the lifetime prevalence of psychiatric disorders in patients with epilepsy. We then used summary data from genome-wide association studies to investigate whether the identified observational associations could be attributed to a shared underlying genetic aetiology using cross-trait linkage disequilibrium score regression. Finally, we assessed the potential bidirectional relationships using two-sample Mendelian randomisation.Results In a cohort of 7 628 495 individuals, we found that almost half of the 94 435 individuals diagnosed with epilepsy were also diagnosed with a psychiatric condition in their lifetime (adjusted lifetime prevalence, 44.09%; 95% confidence interval (CI) 43.78% to 44.39%). We found evidence for a genetic correlation between epilepsy and some neurodevelopmental and psychiatric conditions. For example, we observed a genetic correlation between epilepsy and attention-deficit/hyperactivity disorder (rg=0.18, 95% CI 0.09 to 0.27, p<0.001)—a correlation that was more pronounced in focal epilepsy (rg=0.23, 95% CI 0.09 to 0.36, p<0.001). Findings from Mendelian randomisation using common genetic variants did not support bidirectional effects between epilepsy and neurodevelopmental or psychiatric conditions.Conclusions Psychiatric comorbidities are common in patients with epilepsy. Genetic correlations may partially explain some comorbidities; however, there is little evidence of a bidirectional relationship between the genetic liability of epilepsy and psychiatric conditions. These findings highlight the need to understand the role of environmental factors or rare genetic variations in the origins of psychiatric comorbidities in epilepsy. |
| format | Article |
| id | doaj-art-d26d3fa2b4d144ca881a8e7937fe8ae2 |
| institution | Kabale University |
| issn | 2517-729X |
| language | English |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | General Psychiatry |
| spelling | doaj-art-d26d3fa2b4d144ca881a8e7937fe8ae22025-01-29T16:35:09ZengBMJ Publishing GroupGeneral Psychiatry2517-729X2024-02-0137110.1136/gpsych-2023-101201Psychiatric comorbidities in epilepsy: population co-occurrence, genetic correlations and causal effectsNeil M Davies0Dheeraj Rai1Harriet Forbes2Christina Dalman3Torbjörn Tomson4Daniel Berglind5Michael Lundberg6Cecilia Magnusson7Craig Newschaffer8Brian K Lee9Viktor H Ahlqvist10Paul Madley-Dowd11Christina Dardani12Jessica Rast13Caichen Zhong14Renee M Gardner15Kristen Lyall166 Division of Psychiatry, University College London, London, UK2 Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK1 Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK1 Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden12 Department of Clinical Neuroscience, Karolinska Institute, Stockholm, SwedenDepartment of Global Public Health, Karolinska Institutet, Stockholm, Sweden1 Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden9 Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden10 College of Health and Human Development, The Pennsylvania State University, Pennsylvania, Texas, USA3 Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK2 Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK2 Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK2 Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK9 Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA9 Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA1 Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden9 Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USABackground Psychiatric comorbidities are common in patients with epilepsy. Reasons for the co-occurrence of psychiatric conditions and epilepsy remain poorly understood.Aim We aimed to triangulate the relationship between epilepsy and psychiatric conditions to determine the extent and possible origins of these conditions.Methods Using nationwide Swedish health registries, we quantified the lifetime prevalence of psychiatric disorders in patients with epilepsy. We then used summary data from genome-wide association studies to investigate whether the identified observational associations could be attributed to a shared underlying genetic aetiology using cross-trait linkage disequilibrium score regression. Finally, we assessed the potential bidirectional relationships using two-sample Mendelian randomisation.Results In a cohort of 7 628 495 individuals, we found that almost half of the 94 435 individuals diagnosed with epilepsy were also diagnosed with a psychiatric condition in their lifetime (adjusted lifetime prevalence, 44.09%; 95% confidence interval (CI) 43.78% to 44.39%). We found evidence for a genetic correlation between epilepsy and some neurodevelopmental and psychiatric conditions. For example, we observed a genetic correlation between epilepsy and attention-deficit/hyperactivity disorder (rg=0.18, 95% CI 0.09 to 0.27, p<0.001)—a correlation that was more pronounced in focal epilepsy (rg=0.23, 95% CI 0.09 to 0.36, p<0.001). Findings from Mendelian randomisation using common genetic variants did not support bidirectional effects between epilepsy and neurodevelopmental or psychiatric conditions.Conclusions Psychiatric comorbidities are common in patients with epilepsy. Genetic correlations may partially explain some comorbidities; however, there is little evidence of a bidirectional relationship between the genetic liability of epilepsy and psychiatric conditions. These findings highlight the need to understand the role of environmental factors or rare genetic variations in the origins of psychiatric comorbidities in epilepsy.https://gpsych.bmj.com/content/37/1/e101201.full |
| spellingShingle | Neil M Davies Dheeraj Rai Harriet Forbes Christina Dalman Torbjörn Tomson Daniel Berglind Michael Lundberg Cecilia Magnusson Craig Newschaffer Brian K Lee Viktor H Ahlqvist Paul Madley-Dowd Christina Dardani Jessica Rast Caichen Zhong Renee M Gardner Kristen Lyall Psychiatric comorbidities in epilepsy: population co-occurrence, genetic correlations and causal effects General Psychiatry |
| title | Psychiatric comorbidities in epilepsy: population co-occurrence, genetic correlations and causal effects |
| title_full | Psychiatric comorbidities in epilepsy: population co-occurrence, genetic correlations and causal effects |
| title_fullStr | Psychiatric comorbidities in epilepsy: population co-occurrence, genetic correlations and causal effects |
| title_full_unstemmed | Psychiatric comorbidities in epilepsy: population co-occurrence, genetic correlations and causal effects |
| title_short | Psychiatric comorbidities in epilepsy: population co-occurrence, genetic correlations and causal effects |
| title_sort | psychiatric comorbidities in epilepsy population co occurrence genetic correlations and causal effects |
| url | https://gpsych.bmj.com/content/37/1/e101201.full |
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