Suicidality and Its Risk Factors in Korean People with Epilepsy: A MEPSY Study

Title
Suicidality and Its Risk Factors in Korean People with Epilepsy: A MEPSY Study
Author(s)
서종근[서종근]이장준[이장준]조용원[조용원]이세진김지은[김지은]문혜진[문혜진]박성파[박성파]
Keywords
INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW; ANTIEPILEPTIC DRUGS; DSM-IV; DEPRESSION; ANXIETY; CLASSIFICATION; MULTICENTER; VALIDATION; DISORDERS; SYMPTOMS
Issue Date
201501
Publisher
KOREAN NEUROLOGICAL ASSOC
Citation
JOURNAL OF CLINICAL NEUROLOGY, v.11, no.1, pp.32 - 41
Abstract
Background and Purpose People with epilepsy (PWE) are more likely to experience suicidality, with suicidal ideation and attempts, than people without epilepsy (PWoE). The aims of the present study were to determine 1) the characteristics of suicidality in Korean PWE, 2) whether PWE with suicidality receive psychiatric intervention, and 3) the risk factors for suicidality. Methods Patients who consecutively visited epilepsy clinics at secondary- and tertiary-care hospitals were recruited (n=684), along with age- and sex-matched PWoE (n=229). The presence of current major depressive disorder (MDD), generalized anxiety disorder (GAD), and/or suicidality was established using the Mini International Neuropsychiatric Interview-Plus Version 5.0.0. The Korean version of the Liverpool Adverse Events Profile (K-LAEP) was applied to detect adverse effects of antiepileptic drugs (AEDs). Results Suicidality was present in 208 (30.4%) of the 684 PWE. The rate of suicidality was 4.6 times higher among PWE than PWoE, and 108 (15.7%) PWE had suicidal ideation and had attempted suicide. Among those who had attempted suicide, 40.7% had made at least two attempts. The most common method of suicide attempt was drug overdose (34.9%). Unfortunately, of the 208 PWE with suicidality, 136 (65.4%) did not receive psychiatric intervention. The risk factors for suicidality were MDD [odds ratio (OR)=6.448, 95% confidence interval (CI)=3.739-11.120, p<0.001), GAD (OR=3.561, 95% CI=1.966-6.452, p<0.001), item scores of 3 or 4 on the K-LAEP (OR=2.688, 95% CI=1.647-4.387, p<0.001), and a history of febrile convulsion (OR= 2.188, 95% CI=1.318-3.632,p=0.002). Conclusions Suicidality is more prevalent in PWE than in PWoE. Clinicians should monitor psychiatric disorders and the adverse effects of AEDs in PWE in an attempt to reduce the incidence of suicidal ideation or suicide attempts in this patient population.
URI
http://hdl.handle.net/YU.REPOSITORY/33716http://dx.doi.org/10.3988/jcn.2015.11.1.32
ISSN
1738-6586
Appears in Collections:
의과대학 > 신경과학교실 > Articles
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