Risks of suicidality in adult patients with epilepsy

作     者：Sherifa A Hamed Yaser BE Elserogy Madleen A Abdou Mostafa M Abdellah 

作者机构：Department of Neurology and Psychiatry Assiut University Hospital Department of Clinical Pathology Assiut University Hospital Department of Pharmacology Assiut University Hospital 

出 版 物：《World Journal of Psychiatry》 (世界精神病学杂志)

年 卷 期：2012年第2卷第2期

页      面：33-42页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：Epilepsy Anti-epileptic drugs Psychosocial variables Serotonin Catecholamines Dopamine 

摘      要：AIM: To determine the prevalence and risks of suicidality in a group of patients with epilepsy. METHODS: Included were 200 adult patients and 100 matched healthy subjects. The clinical interview using The Diagnostic and Statistical Manual of Mental Disorders(4th edition), Beck Depression Inventory(2nd edition)(BDI-Ⅱ), Hamilton Anxiety Rating Scale(HAM-A), Yale-Brown Obsessive Compulsive Scale(Y-BOCS) and Eysenck Personality Questionnaire-Revised Rating Scale testings were used for diagnosis and assessment of severity of psychiatric symptoms. Blood concentrations of serotonin, catecholamines and dopamine were also ***: Suicidality was reported in 35%(compared to 9% for controls), of them 80%, 72.86%, 55.71% and 52.9% had depression, anxiety, obsession and aggression respectively. Patients with suicidality had higher scores of BDI-Ⅱ(P = 0.0001), HAM-A(P = 0.0001), and Y-BOCS(P = 0.037) and lower scores of psychotic(P = 0.0001) and extroversion(P = 0.025) personality traits. Regardless the presence or absence of suicidality, patients with epilepsy had low serotonin(P = 0.006), noradrenaline(P = 0.019) and adrenaline(P = 0.0001) levels. With suicidality, significant correlations were identified between:(1) age and scores of BDI-Ⅱ(r = 0.235, P = 0.0001) and HAM-A(r = 0.241, P = 0.046);(2) age at onset and concentrations of noradrenaline(r =-0.502, P = 0.024);(3) duration of illness and scores of BDI-Ⅱ(r = 0.247, P = 0.041), Y-BOCS(r = 0.270, P = 0.025) and neurotic personality trait(r =-0.284, P = 0.018); and(4) doses of antiepileptic drugs and scores of psychotic personality traits(r =-0.495, P = 0.006 for carbamazepine; r =-0.508, P = 0.0001 for valproate).CONCLUSION: This is the first study which systematically estimated the prevalence and risks of suicidality in a homogenous group of patients with epilepsy. This study emphasizes the importance of epilepsy itself as a risk for suicidality and not its treatment.