Nonsuicidal self-injurious behavior in people with epilepsy and non-psychotic mental disorders

Persons with epilepsy (PWE) are at an increased risk for self-injurious behaviors. While suicidal behavior in PWE has been the subject of considerable research, data on nonsuicidal self-injury (NSSI) in PWE remains limited. The aim of this study was to describe the basic characteristics of NSSI in PWE and to identify associated sociodemographic, biographical, psychological, and clinical factors.

A cross-sectional study assessed 209 consecutive adult PWE with non-psychotic mental disorders using the Self-Injurious Thoughts and Behaviors Interview, Beck Depression Inventory, State-Trait Anxiety Inventory, Brief Reasons for Living Inventory, Modified 36-Item Personality Inventory for DSM-5 and ICD-11 Brief Form Plus-Modified, World Health Organization Quality of Life - 100, as well as a case-report form, to collect relevant for the study data.

Lifetime NSSI was reported by 27.7% of PWE, with cutting, carving hitting, picking a wound, biting, and skin scraping being the most common methods. NSSI in PWE was associated with significant features in sociodemographic (born after 1980), biographical (school bullying), clinical (higher levels of depression, anxiety, suicidal ideation and suicide attempts), and psychological profiles (deficits in suicide resilience factors, more pronounced traits of negative affectivity, detachment, antagonism, and psychoticism), and a poorer quality of life.

This is the first study to report methods and other NSSI-related parameters in PWE. NSSI is associated with numerous negative parameters, some of which are potentially modifiable, and may therefore become a target for therapeutic interventions with potential benefit in terms of reducing suicide risk, which is high in this subpopulation of PWE.