Prevalence and determinants of suicidal ideation in adults with epilepsy: A large cross-sectional study

Suicidality is frequent among people with epilepsy (PWE), but studies exploring specific determinants of suicidal ideation remain heterogeneous. We aimed to assess the prevalence of suicidal ideation and associated factors in a large sample of PWE.

We conducted a cross-sectional anonymous survey of adult outpatients with epilepsy by asking them to report sociodemographic characteristics, epilepsy-related information, as well as personal and family history of mental health disorders and suicidality. Recent suicidal ideation was assessed using the ninth item of the Beck Depression Inventory (positive in case of a non-zero score). Between-group comparison and binary logistic regression models were used in search of variables associated with suicidal ideation.

The study included 1001 adult PWE (mean age 36.3 ± 14.1 years, 576 (57.5%) female). The prevalence of recent suicidal ideation was 18.5% (n = 185). Unemployment (OR = 2.126, 95% CI = 1.233 - 3.668, p = 0.007), living in a town (OR = 1.732, 95% CI = 1.073 - 2.797, p = 0.025), history of medication use for anxiety or depression (OR = 2.852, 95% CI = 1.638 -4.965, p < 0.001) and past suicidal ideation (OR = 10.372, 95% CI = 6.272 - 17.154, p < 0.001) were associated with recent suicidal ideation in a multivariable binary regression model (χ² = 291.349, p < 0.001, Nagelkerke R² = 0.450).

Our study suggests that, beyond key sociodemographic factors, past suicidal ideation and a history of medication use for anxiety or depression are independently associated with recent suicidal ideation. These findings suggest that psychiatric history may be more informative than epilepsy-related variables when considering recent suicidal ideation in PWE.