Epilepsy, suicidality, and psychiatric disorders: A bidirectional association

Objective: A study was undertaken to determine whether psychiatric disorders associated with suicide are more common in incident epilepsy than in matched controls without epilepsy, before and after epilepsy diagnosis. Methods: A matched, longitudinal cohort study was conducted in the UK General Prac...

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Bibliographic Details
Published in:Annals of neurology Vol. 72; no. 2; pp. 184 - 191
Main Authors: Hesdorffer, Dale C., Ishihara, Lianna, Mynepalli, Lakshmi, Webb, David J., Weil, John, Hauser, W. Allen
Format: Journal Article
Language:English
Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.08.2012
Wiley-Liss
Wiley Subscription Services, Inc
Subjects:
Adolescent
Adult
Biological and medical sciences
Case-Control Studies
Child
Cohort Studies
Comorbidity
Confidence Intervals
Epilepsy
Epilepsy - epidemiology
Epilepsy - psychology
Female
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Incidence
Male
Medical research
Medical sciences
Mental Disorders - epidemiology
Mental Disorders - psychology
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Suicide - psychology
Suicide - statistics & numerical data
Suicides & suicide attempts
United Kingdom
Young Adult
Mental disorder
Nervous system diseases
Suicide
Epilepsy
Central nervous system disease
Cerebral disorder
ISSN:0364-5134, 1531-8249, 1531-8249
Online Access:Get full text
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Summary:Objective: A study was undertaken to determine whether psychiatric disorders associated with suicide are more common in incident epilepsy than in matched controls without epilepsy, before and after epilepsy diagnosis. Methods: A matched, longitudinal cohort study was conducted in the UK General Practice Research Database. A total of 3,773 cases diagnosed with epilepsy between the ages of 10 and 60 years were compared to 14,025 controls matched by year of birth, sex, general practice, and years of medical records before the index date. We examined first diagnosis of psychosis, depression, anxiety, and suicidality in each of the 3 years before and after the index date and annual prevalence of suicide. Referent diagnoses were eczema and acute surgery. The incidence rate ratio (IRR) was calculated for each year in the study period; the prevalence ratio (PR) was calculated for suicidality. Results: The IRR of psychosis, depression, and anxiety was significantly increased for all years before epilepsy diagnosis (IRR, 1.5–15.7) and after diagnosis (IRR, 2.2–10.9) and for suicidality before epilepsy diagnosis (IRR, 3.1–4.5) and 1 year after diagnosis (IRR, 5.3). The PR was increased for suicide attempt before epilepsy onset (PR, 2.6–5.2) and after onset (PR, 2.4–5.6). Eczema and acute surgery were both associated with epilepsy in the first and third year after diagnosis. Interpretation: Epilepsy is associated with an increased onset of psychiatric disorders and suicide before and after epilepsy diagnosis. These relations suggest common underlying pathophysiological mechanisms that both lower seizure threshold and increase risk for psychiatric disorders and suicide. ANN NEUROL 2012
Bibliography:istex:4EFF9EC379E037EC701D0B7057367801763AD329
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ISSN:0364-5134
1531-8249
1531-8249
DOI:10.1002/ana.23601