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Study Links Epilepsy and Schizophrenia Risk

But an Expert Calls the Risk 'Fairly Low'
WebMD Health News

June 16, 2005 -- There is a "strong association" between epilepsy and schizophrenia, says a Danish study of more than 2 million people.

People with epilepsy had about 2.5 times the risk of schizophrenia as the general population, says the study, which is posted on BMJ Online First.

Yet that's "fairly low," says Charles Raison, MD. Most people with epilepsy probably aren't in danger of schizophrenia, he says.

Raison directs the Behavioral Immunology Clinic at Emory University's medical school. Previously, he was a consulting psychiatrist for the epilepsy service at the University of California at Los Angeles (UCLA).

Raison didn't work on the study, but he read it and put it in perspective for WebMD. He says he wasn't surprised to see a higher risk for epilepsy patients and that clinicians should consider seizures as a possible factor in psychotic patients. "I always wonder about that when we see new onset of psychosis," he says.

Risk Is Still Small for Patients

The increased risk "doesn't mean that patients are going to go insane," says Raison.

He says that schizophrenia risk is very small -- about 1%, in general. But even with the higher risk cited in the study, people with epilepsy still have only a 2-3 in 100 chance of developing schizophrenia. "That's of some concern," says Raison, but "you can get a large increase in risk [and] if the risk is small, you're still very safe."

Put it this way, says Raison: "If I told you you had a 2.5% chance of winning a million bucks in the lottery, you might be excited, but you'd be an idiot to quit your job."

Study's Findings

The Danish study was based on records in a national database of more than 2.2 million people age 15 and older. Researchers reviewed their histories until December 2002, or until they died or were diagnosed with schizophrenia or schizophrenia-like psychosis.

Very few people (1.5%) had epilepsy and only a sliver of them had schizophrenia or related psychosis. Of the epilepsy patients, fewer than one in a hundred (0.8%) were admitted to a hospital for schizophrenia, and 1.5% were admitted for schizophrenia-like psychosis.

The risk was similar for men and women, and for all types of epilepsy. Age and family history of epilepsy or schizophrenia were important. The risk rose with age and was higher in those with no family history of psychosis.

Hospital treatment is free for all Danish residents, so economic factors shouldn't have interfered, say the researchers. They included Ping Qin, an associate professor at Denmark's University of Aarhus.

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