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Causative factors for suicide attempts by overdose in epileptics
M F Mendez1, D J Lanska, R Manon-Espaillat
1Department of Neurology, University Hospitals of Cleveland, Ohio.
Archives of Neurology
|October 1, 1989
Summary
Epileptic suicide attempts are linked to mental health issues like borderline personality disorder and psychosis, not seizure activity or medications. These findings highlight the need for integrated psychiatric care in epilepsy management.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Psychology
Background:
- Epilepsy is associated with a higher risk of suicide.
- Understanding the specific factors contributing to suicide in epilepsy is crucial for prevention.
Purpose of the Study:
- To investigate the causative factors behind the elevated suicide rate in patients with epilepsy.
- To differentiate between seizure-related variables and psychopathologic factors in suicide attempts among epileptic individuals.
Main Methods:
- Retrospective review of 22 patients with idiopathic epilepsy who attempted suicide by overdose.
- Comparison with 44 matched nonepileptic control patients.
- Analysis of seizure variables, psychosocial stressors, and psychiatric diagnoses.
Main Results:
- No significant relationship found between suicide attempts and seizure activity or related variables in most epileptic patients.
- Epileptic patients exhibited higher rates of borderline personality disorder and psychotic disturbances compared to controls.
- Epileptic patients had fewer adjustment disorders but comparable rates of depression.
Conclusions:
- Suicide attempts in epilepsy are predominantly associated with interictal psychopathologic factors, including borderline personality disorder and psychosis.
- Psychosocial stressors, seizure variables, and anticonvulsant medications appear to be less significant contributors.
- Integrated mental health care is essential for managing suicide risk in epilepsy.