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Bidirectional association between autism spectrum disorder and epilepsy in child and adolescent patients: a population-based cohort study

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Abstract

This study aimed to assess whether there is a bidirectional association between autism spectrum disorder (ASD) and epilepsy in child and adolescent patients. The National Health Insurance Research Database of Taiwan was used to conduct two cohort studies of patients who were under 18 years of age during the period 1997–2008. Cohort 1 comprised patients with newly diagnosed ASD but excluded those diagnosed with epilepsy prior to ASD. A non-ASD comparison group was matched to each case in terms of age and sex. Cohort 2 comprised patients with newly diagnosed epilepsy but excluded those diagnosed with ASD prior to epilepsy. A non-epilepsy comparison group was matched to each case in terms of age and sex. We calculated the incidence of epilepsy in patients with ASD and hazard ratio (HR) to estimate the risk of epilepsy in association with ASD in cohort 1, and the reverse in cohort 2. In cohort 1, the incidence of epilepsy was 13.7 in the ASD group and 1.3 in the non-ASD group (per 1000 person-years). The adjusted HR for epilepsy was 8.4 (95 % CI 5.5–12.7) in the ASD group when compared with the non-ASD group. In cohort 2, the incidence of ASD was 3.4 in the epilepsy group and 0.3 in the non-epilepsy group (per 1000 person-years). The adjusted HR for ASD was 8.4 (95 % CI 6.2–11.4) in the epilepsy group when compared with the non-epilepsy group. A bidirectional association was, therefore, found to exist between ASD and epilepsy. These findings implicate that ASD and epilepsy probably share common risk factors. However, further studies are required to reveal more detail on the mechanism of this bidirectional association.

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Acknowledgments

The authors would like to thank Ms. Ching-Lin Chu and Mr. Chien Ting Lin for their administrative support.

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Authors and Affiliations

  1. Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan

    Chien-Chou Su, Mei Hung Chi, Shin-Hsien Lin & Yen Kuang Yang

  2. Institue of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Chien-Chou Su

  3. Addiction Research Center, National Cheng Kung University, Tainan, Taiwan

    Shin-Hsien Lin & Yen Kuang Yang

  4. Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan

    Yen Kuang Yang

  5. Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Yen Kuang Yang

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  1. Chien-Chou Su
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Correspondence to Mei Hung Chi.

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Conflict of interest

The authors report no financial relationships with commercial interests.

Ethical standards

This study was approved by the Ethics Committee for Human Research at the National Cheng Kung University Hospital and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Funding

This work was supported by the Taiwanese Society of Psychiatry (TSOP-2012-R1). This research also received funding (D102-35001 and D103-35A09) from the Headquarters of University Advancement at the National Cheng Kung University, which is sponsored by the Ministry of Education, Taiwan, ROC. The funding institutions of this study had no further role in the study design, the collection, analysis and interpretation of data, the writing of this paper, or the decision to submit for publication.

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Su, CC., Chi, M.H., Lin, SH. et al. Bidirectional association between autism spectrum disorder and epilepsy in child and adolescent patients: a population-based cohort study. Eur Child Adolesc Psychiatry 25, 979–987 (2016). https://doi.org/10.1007/s00787-016-0817-6

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  • DOI: https://doi.org/10.1007/s00787-016-0817-6

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