To characterize mental health and cognitive metrics among people with epilepsy (PWE) compared to the general population.

PWE tend to have poorer mental health and cognitive function, yet the extent of these differences as compared to the general population is not fully known.

We conducted cross-sectional analyses using data from the Centers for Disease Control and Prevention, National Health and Nutrition Examination Survey Questionnaire (NHANES) Data 2013-2018.  Adult PWE taking ≥1 anti-seizure medication(s) were compared with age-, gender- and race/ethnicity-matched controls. We analyzed responses to the PHQ-9, Sleep, Disability, and Physical Functioning questionnaires.

We identified 150 PWE and 6750 matched controls (50% male, median age=53.00), with no significant racial or ethnic differences (p=1). More PWE saw a mental health professional in the last year (24.7% vs. 9.7%, p<0.001). Fewer PWE answered “Not at all” to PHQ-9 questions compared to controls (7.3% vs. 17%) while more endorsed “Nearly every day” for: Having little interest (12.8% vs. 4.6%), Feeling down (7.7% vs. 3.8), Trouble sleeping (23.1% vs. 9.6%), Tired/low energy (23.9% vs. 8.9%), Difficulty concentrating (10.3% vs. 3.3%, p<0.05). More PWE reported daytime sleepiness (38.1% vs. 26.4%), sleeping ≥12 hours (5.7% vs. 0.6%) and difficulty sleeping (44.7% vs. 29.9%)(p<0.006). More PWE had difficulties with cognition (54.5% vs. 16.9%), concentrating (46.7% vs. 11.5%), hearing (16.7% vs. 9.4%), seeing (16.7% vs. 7.3%), dressing/bathing (24.7% vs. 6.6%), doing errands alone (38.7% vs. 9.3%), managing money (38.3% vs. 13.7%), attending social events (39.9% vs. 21.7%), and doing leisure activities at home (18.6% vs. 10.8%)(p<0.001). More PWE reported physical, mental or emotional problems that prevented them from working (59.0% vs. 18.1%) or limited the kind or amount of work they could perform (67.4% vs. 26.2%)(p<0.001).

PWE scored lower on mental health and cognitive questionnaires than controls, highlighting the multi-dimensional impact of epilepsy on patients’ lives.