Suicidal risk, affective dysphoric disorders, and quality-of-life perception in patients with focal refractory epilepsy. Epilepsy Behav 2015 Apr;45:254-60
Date
04/01/2015Pubmed ID
25825368DOI
10.1016/j.yebeh.2015.01.005Scopus ID
2-s2.0-84937764083 (requires institutional sign-in at Scopus site) 27 CitationsAbstract
OBJECTIVES: We aim to study the frequency of (suicidal ideation) in patients with focal refractory epilepsy and its possible association with factors such as perceived QOL (quality of life) and ASDD (affective somatoform dysphoric disorder) using the 2007 ILAE proposal to classify affective disorders of epilepsy.
METHODS: A total sample of 82 patients was divided into two groups depending on the presence of suicidal risk: (A) study group - with suicidal risk and (B) control group - without suicidal risk. Questionnaires, scales, interviews, and clinical charts were evaluated by professionals with expertise in neurology and epileptology (RAM and AGA), psychiatry (AGE), and neuropsychology (FGR). Suicidal risk was evaluated with the M.I.N.I. (Mini-International Neuropsychiatric Interview) suicidal module that specifies the current suicidal risk based on scores. Quality of life was evaluated with the Quality of Life in Epilepsy Inventory - 31 (QOLIE-31) survey. Logistic regression was conducted to ascertain if ASDD and QOL significantly predicted suicidal risk. The results were considered statistically significant when the p-value was <0.05.
RESULTS: Suicidal risk was present in 33 (40.3%) patients. It was classified as severe in 31.7% of the patients, and it was only present in cases with temporal lobe epilepsy (p=0.002). More than half (52%) of patients with ASDD had risk of suicide (p=0.006). The presence of ASDD was found to be a risk factor for suicidal risk (OR=3.86; IC=1.3-12.2). Patients with suicidal risk had a lower QOL score compared with patients without suicidal risk (57.8±16.9 vs. 46.0±18.2; p<0.05), and an affected QOL significantly increased suicidal risk (OR=2.9; CI=1.3-7.8). Multivariate analysis demonstrated that an impaired QOL (OR=2.2) and the presence of ASDD (OR=4.1) significantly increased the probability of having suicidal risk (x(2)=13.6; OR=5.2; p=0.009).
SIGNIFICANCE: Affective somatoform dysphoric disorder and low QOL perception increase, independently, the risk of suicide.
Author List
Andrade-Machado R, Ochoa-Urrea M, Garcia-Espinosa A, Benjumea-Cuartas V, Santos-Santos AAuthor
Rene Andrade-Machado MD, PhD Assistant Professor in the Neurology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultElectroencephalography
Epilepsies, Partial
Female
Humans
Male
Middle Aged
Mood Disorders
Perception
Quality of Life
Retrospective Studies
Risk Factors
Suicidal Ideation
Suicide
Surveys and Questionnaires
