Epilepsy & behavior : E&B · 2026
Delay to diagnosis of epilepsy: A history of a psychiatric disorder and substance use is associated with prior seizures.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Coleman Honor, Rayner Genevieve, Tan K Meng, Carney Patrick W, Perucca Piero, Kwan Patrick, O'Brien Terence J, Berkovic Samuel F, McIntosh Anne M
Аннотация
OBJECTIVE: A substantial proportion of patients with newly diagnosed epilepsy report prior seizures, however little is known about risks for this delay to diagnosis. Here, we examined whether pre-existing alcohol/substance use or psychiatric disorders are associated with prior seizures before a diagnosis of epilepsy or unprovoked seizures.
METHODS: Included were 1,383 adults who attended First Seizure Clinics (FSCs) at Austin Hospital or Royal Melbourne Hospital, Australia, between 2000 and 2010 who were diagnosed with epilepsy or unprovoked seizures. Data were audited from routine epileptologist assessments. Patients with ≥ 1 seizure before their index seizure were coded positive for prior seizures, excluding acute symptomatic seizures. We compared a history of prior seizures in patients with pre-existing psychiatric disorders and/or substance use (including alcohol) to patients without these conditions using logistic regression analyses.
RESULTS: Prior seizures were reported by 37 % (n = 515) of patients. Amongst patients with both substance use and psychiatric conditions, 50 % (31/62) had prior seizures (adjusted OR [aOR] 2.0, 95 %CI 1.2-3.4, p = 0.01 compared with patients with neither condition). Prior seizures occurred in 41 % (68/165) of patients with substance use only (aOR 1.37, 95 %CI 0.96-1.9, p = 0.08), and 34 % (64/187) of those with a psychiatric diagnosis only (aOR 0.93, 95 %CI 0.7-1.3, p = 0.67). Amongst those who were negative for both conditions, 36 % (352/969) had prior seizures.
SIGNIFICANCE: Individuals with a history of both substance use and psychiatric disorders are at risk of delays to specialist epilepsy diagnosis. Screening for prior seizures in patients with these disorders would facilitate informed treatment decisions.
METHODS: Included were 1,383 adults who attended First Seizure Clinics (FSCs) at Austin Hospital or Royal Melbourne Hospital, Australia, between 2000 and 2010 who were diagnosed with epilepsy or unprovoked seizures. Data were audited from routine epileptologist assessments. Patients with ≥ 1 seizure before their index seizure were coded positive for prior seizures, excluding acute symptomatic seizures. We compared a history of prior seizures in patients with pre-existing psychiatric disorders and/or substance use (including alcohol) to patients without these conditions using logistic regression analyses.
RESULTS: Prior seizures were reported by 37 % (n = 515) of patients. Amongst patients with both substance use and psychiatric conditions, 50 % (31/62) had prior seizures (adjusted OR [aOR] 2.0, 95 %CI 1.2-3.4, p = 0.01 compared with patients with neither condition). Prior seizures occurred in 41 % (68/165) of patients with substance use only (aOR 1.37, 95 %CI 0.96-1.9, p = 0.08), and 34 % (64/187) of those with a psychiatric diagnosis only (aOR 0.93, 95 %CI 0.7-1.3, p = 0.67). Amongst those who were negative for both conditions, 36 % (352/969) had prior seizures.
SIGNIFICANCE: Individuals with a history of both substance use and psychiatric disorders are at risk of delays to specialist epilepsy diagnosis. Screening for prior seizures in patients with these disorders would facilitate informed treatment decisions.