Neurodevelopmental and psychiatric comorbidities in children with epilepsy

AIM: To determine the prevalence of neurodevelopmental, psychiatric, and sleep comorbidities, and combined comorbidities among children with 'active' epilepsy. METHOD: All children (born 2003-2021) in the Region Västra Götaland, Sweden with active epilepsy in 2020 and 2021 were included in this population-based cross-sectional study. Diagnoses according to the International Classification of Diseases between 2003 and 2021 for autism spectrum disorder, intellectual disability, attention-deficit/hyperactivity disorder, cerebral palsy, psychological developmental disorders, psychiatric disorders, and sleep disorders and information on associated dispensed drugs, from 31st August 2010, were extracted from all healthcare use from hospitals, outpatient specialist care, habilitation centres, and primary care in the region. RESULTS: Active epilepsy was diagnosed in 0.56% (2146 out of 383 870) of children, 70% had at least one comorbidity, and 40% had diagnoses in three or more of the seven included comorbidity domains. The most frequent comorbidities were in the psychiatric, psychological developmental, sleep, and intellectual disability domains. Associations between comorbidities varied, some being greater in female children than in males. INTERPRETATION: Children with active epilepsy have a high risk of having multiple neurodevelopmental and psychiatric comorbidities. Individualized, comprehensive, and long-term follow-up for possible comorbidities is necessary.