Screening for suicidality and its relation to undiagnosed psychiatric comorbidities in children and youth with epilepsy

Abstract

IntroductionDepression and anxiety are the most common psychiatric comorbidities in children and youth with epilepsy (CYE) and known to contribute to suicidality among them. However, not much is known about suicidality in CYE without established psychiatric comorbidities. Our research aimed to fill this knowledge gap and correlate this latent suicidality with screening tests for depression and anxiety. MethodAfter Institutional Review Board (IRB) approval, CYE who attended the epilepsy clinic or underwent testing in the pediatric epilepsy monitoring unit at the Cleveland Clinic and lacked established psychiatric diagnosis were enrolled. They filled out self-reported, validated scales for screening of depression, anxiety, and suicidality (Center for Epidemiological Studies Depression Scale for Children [CES-DC], Screen for Child Anxiety Related Emotional Disorders [SCARED], and Ask Suicide-Screening Questions [ASQ], respectively). Univariate descriptive statistics along with χ2 test of association and independent Student's t-test were performed for statistical analysis. ResultsA total of 119 (54.6% females) CYE were included in the study. Close to a third (30.2%) of CYE were positive for anxiety on SCARED, and 41.2% were positive for depression based on CSE-DC scoring. A total of 13 (10.9%) CYE indicated suicidality by answering at least one positive response on ASQ. The SCARED had a low positive correlation with the ASQ (r = 0.32) but a moderate positive correlation with the CES-DC (r = 0.64). ConclusionWe found that a small but significant 11% of CYE without any established psychiatric diagnosis expressed suicidality on a self-reported questionnaire. This highlights the importance of using psychiatry screening tests in all CYE. Future research using a larger, diversified cohort is needed to confirm our findings.