1. Patients with Epilepsy: Relationship between their Psycho-emotional Status and Suicidal Behaviour
Ozeraitiene V1, Varvuolyte S1,2, Makaraviciene D3, Stasinskaja N4,
Teliakiene N3, Gaigalaite V1.
1Vilnius University, Lithuania; 2Vilnius Baltupiai Family Medical Center,
3Antakalnis Outpatient Department, GP Center, 4Epilepsy Centre of Vilnius University Hospital, Lithuania
Background
The studies show that epileptic patients (EP) have a stronger tendency toward suicide than healthy people. It should be noted that family doctors are rarely interested in these patients’ emotional status and seldom ask about their suicidal ideation and suicide attempts.
Results
Table 1.
The characteristics of all respondents:
Only 359 (37.2%) of EP were working or studying.
670 (69.4%) have suffered from epilepsy for more than 5 years.
The average seizure frequency was 6 times per month.
Generalized seizures were more common in the age group of years old, focal seizures – in 60-74, both types – in years old.
The ratio was 1.4:1 between generalized and focal (simple and complex) seizures of EP.
Level of Anxiety
Suicidal ideation
Suicidal attempts No
52 (26.1)
16 (24.3)
Light
36 (18.1)
9 (13.6)
Moderate
68 (34.2)
20 (30.3)
Severe
43 (21.6)
21 (31.8)
In all, n (%)
199 (100.0)
66 (100.0)
Table 2.
Level of Depression
Suicidal ideation
Suicidal attempts No
79 (39.7)
19 (28.8)
Light
20 (10.1)
3 (4.5)
Moderate
57 (28.6)
25 (37.9)
Severe
43 (21.6)
In all, n (%)
199 (100.0)
66 (100.0)
Aim
The aim of this study is to assess the relationship between psycho-emotional status of EP and their suicidal behaviour.
Results (cont)
481 (49.8%) had anxiety, which in (79.4%) of the cases could be described as moderate or severe.
305 (31.6%) had depression, (24.4%) of them – moderate or severe.
Every fifth of all EPs had suicidal ideation (n=199; 20.6%).66 (6.8%) individuals admitted having tried to commit a suicide.
The suicidal ideation occurred more in EP with moderate anxiety (χ2=90.35; p<0.001), attempts to commit a suicide were significantly more frequent in EPs with severe anxiety (χ2=46.8; p<0.001) (Table 1).
Suicidal ideation (χ2=110; p<0.001) and suicide attempts (χ2=73,2; p< 0.001) were prevalent in EPs with moderate depression (Table 2).
Conclusions
The symptoms of moderate and severe anxiety in epileptic patients dominate more than moderate and severe depression. A significant relationship between the symptoms of depression and focal complex seizures was determined.
Suicidal ideation was more prevalent among people with moderate symptoms of anxiety and/or depression. Suicidal attempts were found to be more frequent in those with severe symptoms of anxiety and moderate symptoms of depression.
The symptoms of depression and anxiety, suicidal thoughts and suicidal attempts significantly correlated with the seizure frequency.
Materials and methods
The cross-sectional study was performed in the Epilepsy Centre of Vilnius University Hospital and in two outpatient Centers in
966 (408 (42.2%) male and 558 (57.8%) female) patients with epilepsy (average age 36.35±14.12) were interviewed. The socio-demographic, clinical (duration of epilepsy, types and frequency of seizures) data including questions about suicidal ideation and suicidal attempts were analyzed. Beck Depression Inventory Scale (1961) and Hospital Anxiety and Depression Scale (HADS) (1983) were used for evaluation of psycho-emotional state of EPs.
References
Blumer D, Montouris G, Davies K, et al. Suicide in epilepsy: psychopathology, pathogenesis, and prevention. Epilepsy Behav 2002; 3:232–24. Reis S et al. Aggregation of qualitative studies—From theory to practice: Patient priorities and family medicine/general practice evaluations. Patient Education and Counseling. 2007; 65 (2): 214–222. Bella GS, Sander JW. Suicide and epilepsy. Curr Opin Neurol. 2009, 22:174–178. Kanner A. Depression and epilepsy: Epidemiologic and neurobiologic perspectives that may explain their high comorbid occurrence. Epilepsy and Behavior. 2012; 24 (2):