TY - JOUR
T1 - People with epilepsy and intellectual disability
T2 - More than a sum of two conditions
AU - Snoeijen-Schouwenaars, Francesca M.
AU - Young, Charlotte
AU - Rowe, Charles
AU - van Ool, Jans S.
AU - Schelhaas, Helenius J.
AU - Shankar, Rohit
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/11
Y1 - 2021/11
N2 - Background: Around 25% of people with Intellectual Disability (PwID) have comorbid epilepsy with seizures in up to two-thirds being drug-resistant. Little is known of the general characteristics and prescribing practices to this population. Aim: Describe and compare characteristics of two cohorts of PwID and epilepsy in two different countries to inform clinical practice better. Method: An explorative, retrospective, case-note review in a specialist ID community service in England and in an expert center for PwID and epilepsy in the Netherlands was conducted. Information on ID severity, medical/behavioral/psychiatric/neurodevelopmental/genetic comorbidities, psychotropic, and antiepileptic drugs (AEDs) for each cohort was collected. Findings: The English cohort consisted of 167 people (98 males; age range 18–73 years; mild/moderate ID- 35%) and the Dutch cohort of 189 people (111 males; age range 18–85 years; mild/moderate ID – 51%). The two cohorts were comparable in their baseline characteristics. The Dutch had higher rates of physical comorbidity, but less mental or behavioral disorders and were more likely to be on anti-psychotic medication. The mean dosages between three most common AEDs prescribed were similar. The most frequently prescribed drug in both centers is valproate. Three-quarters of the Dutch were on three or more AEDs compared to a third in the English cohort. Conclusions: Structured description of the characteristics, differences, and commonalities of PwID, treatment, and services of both countries is presented. This is the first real-world study to reveal unique characteristics of managing epilepsy for a complex ID population. In particular, it highlights the considerable comorbid psychiatric burden and psychotropic prescribing.
AB - Background: Around 25% of people with Intellectual Disability (PwID) have comorbid epilepsy with seizures in up to two-thirds being drug-resistant. Little is known of the general characteristics and prescribing practices to this population. Aim: Describe and compare characteristics of two cohorts of PwID and epilepsy in two different countries to inform clinical practice better. Method: An explorative, retrospective, case-note review in a specialist ID community service in England and in an expert center for PwID and epilepsy in the Netherlands was conducted. Information on ID severity, medical/behavioral/psychiatric/neurodevelopmental/genetic comorbidities, psychotropic, and antiepileptic drugs (AEDs) for each cohort was collected. Findings: The English cohort consisted of 167 people (98 males; age range 18–73 years; mild/moderate ID- 35%) and the Dutch cohort of 189 people (111 males; age range 18–85 years; mild/moderate ID – 51%). The two cohorts were comparable in their baseline characteristics. The Dutch had higher rates of physical comorbidity, but less mental or behavioral disorders and were more likely to be on anti-psychotic medication. The mean dosages between three most common AEDs prescribed were similar. The most frequently prescribed drug in both centers is valproate. Three-quarters of the Dutch were on three or more AEDs compared to a third in the English cohort. Conclusions: Structured description of the characteristics, differences, and commonalities of PwID, treatment, and services of both countries is presented. This is the first real-world study to reveal unique characteristics of managing epilepsy for a complex ID population. In particular, it highlights the considerable comorbid psychiatric burden and psychotropic prescribing.
KW - Behavioral health
KW - Comorbidity
KW - Mental health
KW - Physical health
KW - Seizures
UR - http://www.scopus.com/inward/record.url?scp=85118807913&partnerID=8YFLogxK
U2 - 10.1016/j.yebeh.2021.108355
DO - 10.1016/j.yebeh.2021.108355
M3 - Article
C2 - 34624802
AN - SCOPUS:85118807913
SN - 1525-5050
VL - 124
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
M1 - 108355
ER -