Abstracts

Rationale: To ascertain the occurrence of comorbid conditions in a cohort of persons with epilepsy (PWE).Methods: We analyzed claims data from the Ohio Medicaid Database between 1992 and 2008. Our epilepsy cohort consisted of patients who were (1) at least 18-year-old; (2) at least one visit of epilepsy diagnosis (ICD-9-CM: 345.xx) or at least two visits of non-febrile convulsions (ICD-9-CM: 780.3 or 780.39); and (3) at least one AED dispensing claim; and (4) at least one year of Medicaid enrollment prior to epilepsy diagnosis. We excluded individuals who enrolled in the Medicare program or the spend-down program. The incident cases of epilepsy were identified between 1994 and 2006. Comorbid conditions were extracted from the epilepsy population and then classified according to the World Health Organization s (WHO) International Classification of Diseases (ICD), 9th Revision, Clinical Modification (ICD-9-CM).Results: There were 20,913 patients who met the study inclusion and exclusion criteria. The mean age was 38 years (range, 18-96 years). The median of observation period was 68.4 months (range, 0-180 months). Each patient had an average of 15 comorbid conditions during the entire period. When grouped by ICD-9-CM chapter, mental disorders were the most common comorbid conditions (85.5%). Other common comorbid conditions included diseases of the respiratory system (75.3%), diseases of the nervous system and sense organs, excluding epilepsy and convulsions (74.5%), injury and poisoning (66.2%). Depressive disorders and alcohol and drug dependence were the two most common conditions among mental disorders. Acute respiratory infections and chronic obstructive pulmonary diseases were the two most common respiratory tract diseases (52.2% and 47.9% respectively). The two most common neurological diseases were migraine (19.7%) and disorders of the peripheral nervous system (19.0%). Injuries and sprains (55.0%) and fractures (20.1%) were the two most common injuries. Top 10 most common individual chronic conditions were depressive disorders (58.5%), alcohol and drug dependence (55.3%), hypertensive diseases (50.4%), chronic pulmonary obstructive diseases (47.9%), anxiety disorder (37.6%), diabetes (28.4%), personality disorders (27.5%), ischemic stroke (20.2%), and ischemic heart disease (20.0%).Conclusions: PWE have high prevalence of both somatic and psychiatric comorbidities. It, however, remains to be determined whether these observed comorbidities are specific to epilepsy.