Seth Heller,1 Rhiannon Wong,1,2 Minami Wada,1,2 Hannah Kwak,1 Andrew Mettias,1,2 Haley Yamamoto,3 Kristal Xie,3 Tyrone Sumibcay,3 Darren DuGas,1 Enrique Carrazana,3 Kore Kai Liow1,3
1 Comprehensive Epilepsy Center and Video-EEG Epilepsy Monitoring Unit & Epilepsy Research Unit, Hawaii Pacific Neuroscience, Honolulu, HI
2 University of Hawaiʻi at Mānoa, Honolulu, HI
3 John A. Burns School of Medicine, University of Hawaiʻi, Honolulu, HI
Patients with epilepsy (PWE) are at increased risk for psychiatric comorbidities, which often remain underdiagnosed and inadequately treated. This study examines how psychiatric comorbidities affect seizure profiles, etiologies, and overall comorbidity burden in PWE in Hawaiʻi. A retrospective chart review was conducted on 500 randomly selected PWE seen at Hawaii Pacific Neuroscience between January 2019 and July 2020. Patients were categorized by self-identified race/ethnicity, and associations between psychiatric comorbidities and clinical variables were analyzed using chi-square and one-way ANOVA.
PWE with psychiatric comorbidities were more likely to present with focal seizures and structural etiologies such as traumatic brain injury and cortical malformations (p < 0.05). This group also had significantly higher rates of migraines, chronic pain, cognitive delay, fibromyalgia, and substance use, including current tobacco use and alcohol abuse history (p < 0.05).
These findings highlight the complex clinical presentation of PWE with psychiatric comorbidities and the need for routine psychiatric screening. Integrating mental health care into epilepsy management may improve neurological outcomes and overall quality of life.
