Evaluation of suicidal ideation in adult people with epilepsy and caregivers in a tertiary center

Abstract

Background: Epilepsy is a risk factor for suicidal ideation (SI). SI still poorly investigated in caregivers of people with epilepsy (PWE). Aim: We aimed to analyze the prevalence and predictors of SI in adults PWE and caregivers. Methods: We analyzed 548 consecutive PWE (60% women; median age 41 [18-83]) and 191 caregivers (72% women; median age 47 [18-82]) followed at Outpatients’ epilepsy clinics from a tertiary center. We used “item nine” (item scores ≥1) of the BDI-II to determine the SI presence. The presence of symptoms of anxiety (with BAI) and depression (with BDI-II) was defined with scores ≥14 (for both PWE and caregivers). The presence of anti-seizure drugs (ASDs) adverse effects was defined with the “Liverpool Adverse Events Profile” score≥46. Epidemiological factors and anxiety were investigated as predictors of SI in caregivers and PWE (along with seizure frequency, epilepsy-type, and ASDs’ adverse events). Results: Depression was present in 41% of the PWE and 32% of the caregivers (p=0.04). Anxiety was observed in 37% of PWE and 33% of caregivers (p=0.32). The SI frequency was higher in PWE (19%) compared to the caregivers (11%; p=0.02). Logistic regression analyses were performed for both groups separately. For the PWE (model accounted for 17%-27%), the most significant predictors were anxiety (OR 4.4, p<0.001), presence of ASDs’ adverse effects (OR 2, p=0.021), recurrent seizures (OR 3, p<0.004), and younger age (OR 0.98, p<0.037). For the caregivers (model accounted for 18-37%), only anxiety (OR 43, p<0.001) predicted SI. Conclusion: Identifying SI predictors is equally necessary for PWE and caregivers.