Suicide in Patients with Epilepsy

Epilepsy and Risk of Suicide: A Population-Based Case–Control Study. Christensen J, Vestergaard M, Mortensen PB, Sidenius P, Agerbo E. Lancet Neurology 2007;6(8):693–698. Background Studies have linked epilepsy with an increased suicide risk, but the association might be modified by psychiatric, dem...

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Bibliographic Details
Published in:Epilepsy Currents
Main Author: Meador, Kimford J.
Format: Article in Journal/Newspaper
Language:English
Published: SAGE Publications 2008
Subjects:
Online Access:http://dx.doi.org/10.1111/j.1535-7511.2008.00231.x
http://journals.sagepub.com/doi/pdf/10.1111/j.1535-7511.2008.00231.x
http://journals.sagepub.com/doi/full-xml/10.1111/j.1535-7511.2008.00231.x
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Summary:Epilepsy and Risk of Suicide: A Population-Based Case–Control Study. Christensen J, Vestergaard M, Mortensen PB, Sidenius P, Agerbo E. Lancet Neurology 2007;6(8):693–698. Background Studies have linked epilepsy with an increased suicide risk, but the association might be modified by psychiatric, demographic, and socioeconomic factors. Methods Suicide cases were identified in the Cause of Death Register in Denmark from 1981 to 1997. Up to 20 controls, matched by sex, birth year, and calendar date, were assigned to each suicide case. Findings We identified 21,169 cases of suicide and 423,128 controls. In total, 492 (2.32%) individuals who committed suicide had epilepsy compared with 3,140 (0.74%) controls, corresponding to a three times higher risk (rate ratio [RR] 3.17 [95% CI 2.88–3.50]; p < 0.0001). The RR remained high after excluding those with a history of psychiatric disease and adjusting for socioeconomic factors (1.99, 1.71–2.32; p < 0.0001). The highest risk of suicide was identified in patients with epilepsy and comorbid psychiatric disease, even after adjusting for socioeconomic factors (13.7, 11.8–16.0; p < 0.0001). In individuals with epilepsy, the highest risk of suicide was found during the first half year after diagnosis was made (5.35, 3.43–8.33; p < 0.0001), and was especially high in those with a history of comorbid psychiatric disease (29.2, 16.4–51.9; p < 0.0001). Interpretation Individuals with epilepsy have a higher risk of suicide, even if coexisting psychiatric disease, demographic differences, and socioeconomic factors are taken into account. Our study identifies people with newly diagnosed epilepsy as a vulnerable group that require special attention. Depression and Suicide in Epileptic Victims: A Population-Based Study of Suicide Victims during the Years 1988–2002 in Northern Finland. Mainio A, Alamäki K, Karvonen K, Hakko H, Särkioja T, Räsänen P. Epilepsy Behav 2007; 11:389–393. Patients with epilepsy are known to have comorbid affective disorders and a higher risk for ...