Psychiatric comorbidities and all-cause mortality in epilepsy: A nationwide cohort study.

Background: People with epilepsy (PWE) having comorbid psychiatric conditions may be at greater risk of death. We aimed to determine the association between psychiatric disorders and all-cause mortality among PWE after adjustment for somatic comorbidities. Methods: Based on data from the National Health Insurance Fund, a Cox survival analysis was done within a retrospective open cohort of all PWE (≥12 years) in Lithuania between January 2014 and June 2020. Cox models comparing mortality between PWE with or without psychiatric comorbidities were adjusted for sex, age, hospitalizations, and the epilepsy-specific comorbidity index. Results: Of 47,964 PWE (age Md = 49, IQR = 34-62 years, 60.3% male, follow-up Md = 4.4, IQR = 2.1-6.1 years), 10,290 (21.5%) died during the study. The diagnosis of any psychiatric disorder ( Conclusions: Our results suggest that psychiatric comorbidities increase all-cause mortality among PWE through their association with coexisting somatic conditions as only substance use disorders and self-harm were independently related to elevated all-cause mortality. Future clinical interview-based studies should explore the relationship between mortality in epilepsy and psychiatric comorbidities while adjusting for somatic comorbidities.