J Clin Neurol.  2015 Jan;11(1):32-41. 10.3988/jcn.2015.11.1.32.

Suicidality and Its Risk Factors in Korean People with Epilepsy: A MEPSY Study

• Seo JG
• Lee JJ
• Cho YW
• Lee SJ
• Kim JE
• Moon HJ
• Park SP

• KMID: 2179570
• DOI: http://doi.org/10.3988/jcn.2015.11.1.32

Abstract

BACKGROUND AND PURPOSE
People with epilepsy (PWE) are more likely to experience suicidality, with suicidal ideation and attempts, than people without epilepsy (PWoE). The aims of the present study were to determine 1) the characteristics of suicidality in Korean PWE, 2) whether PWE with suicidality receive psychiatric intervention, and 3) the risk factors for suicidality.
METHODS
Patients who consecutively visited epilepsy clinics at secondary- and tertiary-care hospitals were recruited (n=684), along with age- and sex-matched PWoE (n=229). The presence of current major depressive disorder (MDD), generalized anxiety disorder (GAD), and/or suicidality was established using the Mini International Neuropsychiatric Interview-Plus Version 5.0.0. The Korean version of the Liverpool Adverse Events Profile (K-LAEP) was applied to detect adverse effects of antiepileptic drugs (AEDs).
RESULTS
Suicidality was present in 208 (30.4%) of the 684 PWE. The rate of suicidality was 4.6 times higher among PWE than PWoE, and 108 (15.7%) PWE had suicidal ideation and had attempted suicide. Among those who had attempted suicide, 40.7% had made at least two attempts. The most common method of suicide attempt was drug overdose (34.9%). Unfortunately, of the 208 PWE with suicidality, 136 (65.4%) did not receive psychiatric intervention. The risk factors for suicidality were MDD [odds ratio (OR)=6.448, 95% confidence interval (CI)=3.739-11.120, p<0.001], GAD (OR=3.561, 95% CI=1.966-6.452, p<0.001), item scores of 3 or 4 on the K-LAEP (OR=2.688, 95% CI=1.647-4.387, p<0.001), and a history of febrile convulsion (OR= 2.188, 95% CI=1.318-3.632, p=0.002).
CONCLUSIONS
Suicidality is more prevalent in PWE than in PWoE. Clinicians should monitor psychiatric disorders and the adverse effects of AEDs in PWE in an attempt to reduce the incidence of suicidal ideation or suicide attempts in this patient population.

Keyword

suicide; epilepsy; depression; anxiety; adverse effect; risk factor

MeSH Terms

Anticonvulsants
Anxiety
Anxiety Disorders
Depression
Depressive Disorder, Major
Drug Overdose
Epilepsy*
Humans
Incidence
Risk Factors*
Seizures, Febrile
Suicidal Ideation
Suicide
Suicide, Attempted
Anticonvulsants

Figure

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  Fig. 1 Method of suicidal attempt in eligible patients (n=108).

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  Fig. 2 The frequency of psychiatric intervention in patients with suicidality (n=208). The time of psychiatric intervention (currently or previously) was determined as whether patients were receiving psychiatric intervention at the enrollment of the study.

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