Women Veterans with epilepsy and psychiatric comorbidities: a call to action
Abstract: Over 3 million adults live with active epilepsy in the United States,1 and it is estimated that 1 in 26 people will develop it in their lifetime. This is a compelling population for study given that compared to the non-veteran population, veterans have an increased risk of acquired epilepsy due to traumatic brain injuries. Moreover, women with epilepsy face more treatment decisions given drug interactions with contraceptives, pregnancy complications, and teratogenesis risks. Ultimately, women with epilepsy who are veterans face uniquely challenging barriers, and understanding the burden of psychiatric conditions is necessary to tailor care and interventions. These findings have important implications for clinical care, access to care, and research. First, this research should heighten awareness for clinicians of the increased burden of psychiatric comorbidities women veterans with epilepsy. Screening and treatment for these conditions, including implementing previously studied interventions and developing new ones tailored to this population, should be prioritized. Second, these findings are important considering documented access to care challenges for veterans. With the compounding effects of stigma and access to psychiatric care, this high prevalence of psychiatric comorbidities, with over half experiencing depression, should motivate efforts to increase access to and use of specialty care among veterans; with special attention to those who may be at the highest risk for these comorbidities. Finally, these findings provide the groundwork for additional research to understand the patterns and causes of these conditions and health outcomes. To advance health equity efforts, it is critical that we address the challenges, including the psychiatric comorbidities, that women veterans with epilepsy face to achieving optimal health.