Suicidality and Its Risk Factors in Korean People with Epilepsy: A MEPSY Study
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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 thepresent study were to determine 1) the characteristics of suicidality in Korean PWE, 2) whetherPWE with suicidality receive psychiatric intervention, and 3) the risk factors for suicidality. Methods Patients who consecutively visited epilepsy clinics at secondary- and tertiary-carehospitals were recruited (n=684), along with age- and sex-matched PWoE (n=229). The presenceof 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 detectadverse effects of antiepileptic drugs (AEDs). Results Suicidality was present in 208 (30.4%) of the 684 PWE. The rate of suicidality was 4.6times 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 monitorpsychiatric 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.
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 thepresent study were to determine 1) the characteristics of suicidality in Korean PWE, 2) whetherPWE with suicidality receive psychiatric intervention, and 3) the risk factors for suicidality. Methods Patients who consecutively visited epilepsy clinics at secondary- and tertiary-carehospitals were recruited (n=684), along with age- and sex-matched PWoE (n=229). The presenceof 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 detectadverse effects of antiepileptic drugs (AEDs). Results Suicidality was present in 208 (30.4%) of the 684 PWE. The rate of suicidality was 4.6times 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 monitorpsychiatric 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.
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