Predictors of Suicidal Ideation in People with Epilepsy Living in Korea

Background and Purpose The risk of suicide or suicide attempts is reported higher in people with epilepsy (PWE) than in the general population Although epileptic, psychiatric, and psychosocial factors ate known risk factors for suicide or suicide attempt, no studies have evaluated the predictors of the severity of suicidal ideation-which is a wanting sum for suicide attempts-in PWE Therefore, we measured the severity of suicidal ideation and its risk factors Methods Consecutive PWE who were medicated with antiepileptic during (AEDs) and attended epilepsy clinic were included in the study The subjects completed self-reported questionnaires, which included the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Symptom Checklist-90-Revised (SCL-90-R), and Scale for Suicide Ideation-Beck (SSI-Beck) We compared the patients' demographic and clinical variables, and BDI, BAI. and SCL-90-R scores with their SSI-Beck score, and used our findings to determine the predictors for suicidal ideation. Results In total, 257 PWE new enrolled in the study SSI-Beck scores correlated strongly with several seizure-related variables, duration of education, IQ, BDI and BAI scores, and nine domains of the SCL-90-R questionnaire However, the strongest predictor for suicidal ideation was BDI score (beta=0.41, p<0 001), followed by several SCL-90-R domains, such as obsessive-compulsive (beta=-0 39, p<0 001), depression (beta=0 38, p<0 001), hostility (beta=0.22. p=0.002), paranoid ideation (beta=0.17, p=0 01), and IQ (beta=-0 10, p=0 017) These variables explained 59% of the variance in the SSI-Beck score The seizure-related variables that influenced the BDI score were seizure frequency, duration of education, MRI abnormality. and number of AEDs However, these variables explained only 18% of the variance in the BDI score Conclusions Maim risk factors for suicidal ideation in PWE were depressive and psychiatric symptoms rather than seizure-related variables Therefore, clinicians should focus on screening for depression and other psychiatric problems and treat them appropriately in order to reduce suicidal behavior in PWE. Since seizure-related variables also exhibited a minor role in determining depressive symptoms, stronger seizure-related risk factors for depression should be sought, such as seizure severity or psychosocial factors, to minimize suicidal behavior J Clin Neurol 2010;6:81-88