Citation

Rani RA, Razali R, Hod R, Mohamad K, Rani SAM, Yahya WNNW, Sahathevan R, Remli R, Law ZK, Ibrahim NM, Tan HJ. Neurol. Asia 2014; 19(2): 129-136.

Copyright

(Copyright © 2014, ASEAN Neurological Association)

DOI

unavailable

PMID

unavailable

Abstract

Background and Objective: Epilepsy and depression are interlinked and lead to an increased risk of suicidal ideation and suicide. Although depression is a significant risk factor for suicidal ideation in epilepsy patients, epilepsy itself is independently associated with suicidal ideation. There are various other factors related to epilepsy that further increase this risk.

METHODS: We conducted a study of suicidal-ideation amongst epilepsy patients in our centre. Demographic data and clinical history were obtained while suicidal ideation was determined using the Columbia Suicide Severity Rating Scale (C-SSRS). Beck's Depression Inventory-II (BDI-II) was used to identify presence of depression.

RESULTS: We recruited 80 patients with epilepsy and an equal number of controls. Epilepsy patients were more likely to be depressed with a mean BDI-II score of 9.09 ±6.48 compared to controls who has a mean score of 5.56 ±4.56. The proportion of epilepsy patients with suicidal ideation was 33.75% vs. 5.00% in the control group (p<0.001). Epilepsy patients were 9.68 times more likely to have suicidal ideation compared to controls: OR 9.68 (95% CI 3.19, 29.28). Amongst epilepsy patients, those with suicidal ideation were more likely to be on 3 or more anti-epileptic drugs (10.00% vs. 6.25%, p=0.016), with a higher seizure frequency (11.25% vs. 2.50%, p=0.004) and higher incidence of previous head surgery (10.00% vs. 5.00%, p=0.022).

CONCLUSION: Suicidal ideation was significantly prevalent amongst epilepsy patients especially in patients with frequent seizures, use of ≥ 3 anti-epileptic drugs or prior head surgery. Our findings suggest that assessment of suicidal ideation is pertinent in high-risk epilepsy patients and should be routinely carried out in the clinical setting.

Language: en

Keywords

adolescent; adult; human; female; male; incidence; Malaysia; suicidal ideation; depression; prevalence; risk assessment; morbidity; epilepsy; article; major clinical study; controlled study; anticonvulsive agent; demography; high risk patient; Beck Depression Inventory; psychological rating scale; disease duration; medical history; tertiary care center; columbia suicide severity rating scale; head and neck surgery; patient history of surgery