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Suicidality and epilepsy: A systematic review and meta-analysis.
Haijiao Wang1,2, Yu Zhang1,3, Ge Tan1
1Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Frontiers in Psychiatry
|April 17, 2023
Summary
Epilepsy significantly increases the risk of suicidality, with rates of suicidal ideation at 19.73% and attempts at 5.96% in patients with epilepsy (PWE). Early identification and prevention strategies are crucial for PWE due to this elevated risk.
Area of Science:
- Neuroscience
- Psychiatry
- Public Health
Background:
- Epilepsy is a chronic neurological disorder affecting millions worldwide.
- Suicidality, encompassing ideation, attempts, and completed suicide, is a significant public health concern.
- The association between epilepsy and suicidality requires comprehensive evaluation.
Purpose of the Study:
- To systematically evaluate the association between epilepsy and suicidality.
- To quantify the prevalence of suicidal ideation, attempts, and completed suicide in patients with epilepsy (PWE).
- To compare the risk of suicidality in PWE versus the general population.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, Embase, Cochrane) from 1946 to June 2021.
- Study quality was assessed using the Newcastle-Ottawa Scale.
- Pooled odds ratios (OR) and crude rates for suicidality outcomes in PWE were calculated.
Main Results:
- The study included 88 articles with over 1.1 million PWE and 6.9 million controls.
- Pooled rates for PWE were: suicidal ideation 19.73%, suicide attempts 5.96%, and completed suicide 0.24%.
- PWE exhibited a significantly higher risk for overall suicidality (OR 2.60), including ideation (OR 2.70), attempts (OR 2.74), and completed suicide (OR 2.36).
Conclusions:
- Patients with epilepsy have a substantially increased risk of suicidality.
- Specific epilepsy types, such as temporal lobe epilepsy and drug-resistant epilepsy, may confer higher risks.
- Clinical awareness and proactive management are essential for early identification and prevention of suicidality in PWE.
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