Abstract
People with epilepsy (PWE) have an increased suicide prevalence. This study aimed to identify the risk factors for suicidal tendency among PWE in West China. A nested case–control study was designed in a cohort of patients with epilepsy (n = 2087). In total, 28 variates were calculated. In the univariate analysis, unemployment, low income, seizure frequency, seizure-free time, infectious or structural etiology, levetiracetam or phenobarbital use, anxiety, depression, and stigma were associated with suicidal tendency. A multivariate analysis indicated that unemployment (odds ratio [OR] 5.74, 95% confidence interval [CI] 2.13–15.48), levetiracetam use (OR 2.80, 95%CI 1.11–7.05), depression (C-NDDI-E score ≥ 13; OR 3.21, 95%CI 1.26–8.21), and stigma (SSCI score ≥ 16; OR 6.67, 95%CI 1.80–24.69) were independently associated with suicidal tendency. Conditional inference tree analysis indicated that SSCI and C-NDDI-E scores could effectively identify patients with suicidal tendency. Thus, this study suggests that unemployment, levetiracetam use, depression, and stigma are independent risk factors for suicidal tendency in PWE in China.
Highlights
People with epilepsy (PWE) have an increased suicide prevalence
Considering the heavy burden and the serious consequences suicidality has on society, it is necessary and of interest to identify the clinical correlation of suicidal tendency in this population reveal the associated factors that may eventually lead to better control and prevention of suicide in PWE
During the 2018 and 2019 follow-up, we evaluated all patients in the database using the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E), seven-item anxiety scale (GAD-7), Stigma Scale for Chronic Illnesses 8-item version (SSCI-8), and the Mini International Neuropsychiatric Interview (MINI)
Summary
This study aimed to identify the risk factors for suicidal tendency among PWE in West China. Unemployment, low income, seizure frequency, seizure-free time, infectious or structural etiology, levetiracetam or phenobarbital use, anxiety, depression, and stigma were associated with suicidal tendency. This study suggests that unemployment, levetiracetam use, depression, and stigma are independent risk factors for suicidal tendency in PWE in China. The risk factors for suicide include being female, unemployment, low income, high seizure frequency, some AEDs, seizure-preceding auras, temporal epilepsy, psychiatric disorders, and antidepressant d rugs[10,13,14]. The risk of suicide was 2.6 times higher among PWE with psychiatric disorders, including major depression, anxiety, and psychosis, compared to those without mental illnesses[21]. We conducted this study using the database of the West China Hospital epilepsy center[24,25,26]
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