Psychiatric comorbidity and suicidal behavior in epilepsy: A community-based case-control study

Abstract

Purpose: To provide information about psychiatric comorbidity and suicidal behavior in people with epilepsy compared to those without epilepsy from a community sample in Brazil. Methods: An attempt was made to evaluate all 174 subjects with epilepsy (cases) identified in a previous survey. For every case identified, an individual without epilepsy (control) matched by sex and age was selected in the same neighborhood. A structured interview with validated psychiatric scales was performed. One hundred and fifty-three cases and 154 controls were enrolled in the study. Results: People with epilepsy had anxiety more frequently [39.4% vs. 23.8%, odds ratio (OR) 2.1, 95% confidence interval (CI) 1.2-3.5; p = 0.006], depression (24.4% vs. 14.7%, OR 1.9, 95% CI 1.01-3.5; p = 0.04), and anger (55.6% vs. 39.7%, OR 1.9, 95% CI 1.2-3.1; p = 0.008). They also reported more suicidal thoughts [36.7% vs. 23.8%, OR 1.8, 95% CI 1.1-3.1; p = 0.02), plans (18.2% vs. 3.3%, OR 2.0, 95% CI 1.0-4.0; p = 0.04), and attempts (12.1% vs. 5.3%, OR 2.4, 95% CI 1.1-3.2, p = 0.04) during life than controls. Conclusions: These findings call attention to psychiatric comorbidity and suicidal behavior associated with epilepsy. Suicide risk assessment, mental evaluation, and treatment may improve quality of life in epilepsy and ultimately prevent suicide. © 2009 International League Against Epilepsy.