Eating disorders in epilepsy linked to psychiatric comorbidities

09 Sep 2023
Eating disorders in epilepsy linked to psychiatric comorbidities

Eating disorders may occur among teens with epilepsy, especially those with psychiatric comorbidities, such as depression, anxiety, and suicidality, according to a study.

The study included adolescents with epilepsy seen in a single centre. Those who had comorbid eating disorders were compared with two control groups of adolescents with only epilepsy and only eating disorders. None of the participants had intellectual disability or autism spectrum disorder.

A total of 376 participants were included in the analysis. Of these, 84 adolescents had both epilepsy and eating disorders, 135 had only epilepsy, and 157 had only eating disorders.

The rate of eating disorders among participants with epilepsy was 7.0 percent (95 percent confidence interval [CI], 5.6–8.5) overall, 11.3 percent (95 percent CI, 8.8–14.3) in females, and 3.1 percent (95 percent CI, 1.9–4.8) in males. The median time difference between the onset of epilepsy and an ED was 1.6 years.

Among participants with epilepsy, those with an eating disorder tended to be females (p=0.001) and have a lower z-score body mass index percentile (p<0.001). Epilepsy type, seizure frequency, or seizure duration did not factor in having or not having eating disorders.

Among participants with eating disorders, those with epilepsy had a younger onset of their eating disorders (p<0.001), were more likely to be males (p=0.007), and had more cases of anorexia-nervosa-restrictive type (p<0.001) and fewer cases of bulimia nervosa (p=0.04) and binge eating disorder (p=0.003).

Finally, participants with epilepsy and a comorbid eating disorder were more likely to have psychiatric comorbidities such as depression, anxiety, and suicidality compared with those who had only epilepsy or eating disorders.

The findings underscore the importance of screening for eating disorders in intellectually intact female and male teens with epilepsy, irrespective of their epilepsy type. If disturbed eating behaviours or eating disorders are identified, these young people should be further evaluated to detect other psychopathologies, including suicidality.

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