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Clinical factors associated with suicide risk independent of depression in persons with epilepsy

Soo Jeong Kim¹, Hyo Jae Kim¹, Ji-Ye Jeon²

¹Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

|June 17, 2020

Abstract

Purpose:

We determined whether factors related to epilepsy are associated with a risk of suicide independent of depression in persons with epilepsy.

Method:

This cross-sectional study included adults with epilepsy. Suicidality and depression were assessed with the Mini International Neuropsychiatric Interview (MINI). Patients were divided into two age groups (≤ 40 vs. > 40 years). Presence of suicide risk was defined as a MINI suicidality score ≥ 1. A stepwise logistic regression analysis was conducted.

Results:

A total of 212 participants were recruited (52.4 % men). Suicide risk and depression were noted in 31.6 % and 22.2 % of participants, respectively. An antiepileptic drug load ≥ 1 (odds ratio [OR], 4.093-4.152) was significantly associated with a risk of suicide, independent of depression (OR, 5.794), and a past or family history of psychiatric disorders (OR, 2.677). When stratified by age, pregabalin usage (OR, 13.403) in the younger group and high seizure frequency (≥ 1 per month) (OR, 5.748) in the older group were associated with a risk of suicide independent of current depression.

Conclusion:

The risk of suicide in persons with epilepsy may be associated with epilepsy-related factors such as a high antiepileptic drug load, frequent seizures, and use of pregabalin, independent of depression. Such risk factors may vary depending on the age of the patient.

Keywords:

Antiepileptic drug Depression Epilepsy Pregabalin Suicidality

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