Psychiatric disease burden profiles among veterans with epilepsy: The association with health services utilization

Objective: This brief report describes patterns of psychiatric comorbidities among patients with epilepsy and their relationship with health care utilization. Methods: The study identified psychiatric comorbid conditions in a cohort of veterans identified as having epilepsy in fiscal year 1999. From these diagnoses, nine psychiatric disease burden profiles were created. Logistic regression examined variation in emergency, neurology, and primary care for groups having different profiles and compared them with those with only epilepsy. Results: Of the 23,752 individuals identified, 48% had comorbid psychiatric conditions; most had multiple psychiatric diagnoses. Compared with patients with epilepsy only, those with co-morbid psychiatric conditions were more likely to have emergency care and high primary care utilization; those with serious mental illness (psychotic disorders) were less likely to receive neurology care. Conclusions: Multiple co-occurring psychiatric diseases are common among patients with epilepsy. Addressing the mental health and medical needs of these patients, particularly those with serious mental illness, represents a challenge for health organizations.