IntroductionNutrient deficiency and immune and inflammatory disturbances in early life may compromise neurodevelopment and be implicated in the aetiology of psychiatric disorders. However, current evidence is limited by its predominantly observational nature. COpenhagen Prospective Study on Neuro-PSYCHiatric Development (COPSYCH) is a research alliance between Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research with the overall aim to investigate effects of prenatal and early life exposures on neurodevelopment at 10 years. COPSYCH will investigate the impact of prenatal n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) and high-dose vitamin D supplementation on neurodevelopment reflected by brain development, neurocognition and psychopathology. Moreover, the neurodevelopmental impact of early life exposures such as infections, low grade inflammation and the gut microbiome will be scrutinised.Methods and analysisCOPSYCH is based on the prospective and ongoing COPSAC2010 birth cohort of 700 mother–child pairs. Randomised controlled trials of supplementation with n-3 LCPUFA and/or high-dose vitamin D or placebo in the third trimester were embedded in a factorial 2×2 design (ClinicalTrials.gov: NCT01233297 and NCT00856947). This unique cohort provides deep phenotyping data from 14 previous clinical follow-up visits and exposure assessments since birth. The ongoing 10-year visit is a 2-day visit. Day 1 includes a comprehensive neurocognitive examination, and assessment of psychopathological dimensions, and assessment of categorical psychopathology. Day 2 includes acquisition of brain structural, diffusion and functional sequences using 3 Tesla MRI. Study outcomes are neurocognitive, psychopathological and MRI measures.Ethics and disseminationThis study has been approved by the Danish National Committee on Health Research Ethics and The Danish Data Protection Agency. The study is conducted in accordance with the guiding principles of the Declaration of Helsinki. Parents gave written informed consent before enrolment.

Background: Drug-resistant-epilepsy (DRE) is a major challenge in adult patients with epilepsy. The majority of previous studies evaluating the risk factors of DRE have been conducted in children. Therefore, this study aimed to investigate the prevalence of DRE and its associated factors in adults.Methods: All patients aged over 12 years with an established diagnosis of epilepsy since at least one year before the admission who were admitted with seizure to the neurology ward of a tertiary care hospital were consecutively included from 20th March 2014 to 19th March 2020. Patients were classi ed into two groups of DRE and non-DRE groups. The archived-les of the patients were retrospectively reviewed and the data were extracted and recorded in a pre-prepared checklist.Results: A total of 436 patients were investigated. The most common causes of epilepsy were idiopathic (53.9%), vascular (22.5%), and CP/developmental disorders (8.3%). There was no signi cant difference between DRE and non-DRE patients in terms of age, sex, seizure type (generalized/partial). Vascular causes were more prevalent in the non-DRE group, and idiopathic, post-traumatic/surgery, MS/degenerative, poor compliance, CP/developmental disorders, and space-occupying lesions were more prevalent in the DRE group. In multivariate regression analysis only the presence of CP/developmental disorders was independently associated with a higher probability of DRE (adjusted OR= 2.170, 95% CI = 1.017 to 4.633, p = 0.045). Conclusion:The prevalence of DRE is still considerably high. Therefore, considering its serious consequences, more investigations should be carried out to determine proper strategies for reducing its incidence. We found the history of CP/developmental disorders to be independently associated with DRE. Therefore, perinatal care to reduce the incidence of CP/developmental disorders and encouraging these patients to use their medications accurately may be helpful.

Background: Drug-resistant-epilepsy (DRE) is a major challenge in adult patients with epilepsy. The majority of previous studies evaluating the risk factors of DRE have been conducted in children. Therefore, this study aimed to investigate the prevalence of DRE and its associated factors in adults. Methods: All patients aged over 12 years with an established diagnosis of epilepsy since at least one year before the admission who were admitted with seizure to the neurology ward of a tertiary care hospital were consecutively included from 20th March 2014 to 19th March 2020. Patients were classified into two groups of DRE and non-DRE groups. The archived-files of the patients were retrospectively reviewed and the data were extracted and recorded in a pre-prepared checklist. Results: A total of 436 patients were investigated. The most common causes of epilepsy were idiopathic (53.9%), vascular (22.5%), and CP/developmental disorders (8.3%). There was no significant difference between DRE and non-DRE patients in terms of age, sex, seizure type (generalized/partial). Vascular causes were more prevalent in the non-DRE group, and idiopathic, post-traumatic/surgery, MS/degenerative, poor compliance, CP/developmental disorders, and space-occupying lesions were more prevalent in the DRE group. In multivariate regression analysis only the presence of CP/developmental disorders was independently associated with a higher probability of DRE (adjusted OR= 2.170, 95% CI = 1.017 to 4.633, p = 0.045).Conclusion: The prevalence of DRE is still considerably high. Therefore, considering its serious consequences, more investigations should be carried out to determine proper strategies for reducing its incidence. We found the history of CP/developmental disorders to be independently associated with DRE. Therefore, perinatal care to reduce the incidence of CP/developmental disorders and encouraging these patients to use their medications accurately may be helpful.