People who have epilepsy are 11 times more likely to die prematurely compared with those who do not have the condition, and the risk is even higher for those with mental illness, according to research published in the The Lancet.

The study was carried out by researchers from the University of Oxford and University College London in the UK, who analyzed 69,995 patients in Sweden suffering from epilepsy over a 41-year period.

The researchers looked at the risks and causes of premature mortality in people with epilepsy, including suicide, accidents and assaults.

These circumstances were assessed and compared with 660,869 age-matched and sex-matched individuals without epilepsy from the general population. In addition, 81,396 healthy siblings of the epilepsy sufferers were assessed for the influence of genetic or early environmental risk factors.

Throughout the study, 6,155 (9%) people with epilepsy died compared with 4,892 (0.7%) of the general population who do not suffer from the disorder.

The most common cause of death in epilepsy sufferers was found to be what the researchers call “external causes”, with 15.8% dying from suicides, accidents and assaults. Three-quarters of these 15.8% had been diagnosed with a mental disorder, and substance misuse and depression were the biggest mental health risk factors.

Seena Fazel of the University of Oxford, says:

Our results have significant public health implications, as around 70 million people worldwide have epilepsy, and they emphasize that carefully assessing and treating psychiatric disorders as part of standard checks in persons with epilepsy could help reduce the risk of premature death in these patients.”

“Our study also highlights the importance of suicide and non-vehicle accidents as major preventable causes of death in people with epilepsy.”

However, the researchers found that the risk of early mortality in epilepsy sufferers without mental illness did not differ compared with the risk in their siblings. The same was found when comparing mentally sound epilepsy sufferers with the general population.

The researchers say this means that “epilepsy could be a single risk factor for all-cause and external causes of death.”

Epilepsy is a neurological disorder of the brain characterized by recurrent seizures or ‘fits’. According to a World Health Organization factsheet, around 50 million people worldwide have the neurological disorder.

Ley Sander of University College London, says the results from this research show that people with epilepsy who have comorbidities – who have other, separate conditions at the same time – should be treated with more care.

He says:

For a condition with such high comorbidity, management of such comorbidities should be part of a holistic approach.”

“The presence of comorbid disorders is associated with increased healthcare needs, poorer health-related quality of life, and is a major driver for premature mortality.”

“Prevention, identification, and adequate treatment of comorbid disorders should be an important part of epilepsy management at all levels of care.”