Factors associated with suicidal ideation in an epilepsy center in Northern New England

Suicidal ideation (SI), defined as thoughts and feelings of ending one's life, is a known risk factor for completed suicide. Although studies show that rates of SI are elevated in persons with epilepsy (PWE) compared to the general population, it is presently unclear how disease, social, and psychological factors contribute to its frequency and severity. With an overarching goal to develop a screening tool for suicide prevention, the objective of this study was to understand the rate, severity, and factors associated with SI in a large cohort of PWE. A generalized linear mixed model was used to test the relationship between changes in SI and disease, social, and psychological variables in 2450 PWE over a period of four years. The prevalence of SI was 23.6%. Associated disease factors included increased seizure frequency, severity, and recency. SI was impacted by employment status, but not by driving. Depression scores and aggression were highly associated with frequency and severity of SI. These findings highlight that disease, social, and psychological factors impact levels of SI in PWE and that screening for suicide prevention in PWE should include measures of such factors.