Epilepsy sufferers have higher suicide risk

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The suicide rate among people with epilepsy is 22% higher than the general population, according to a study released by the US Centres for Disease Control and Prevention.

Suicide is one of the leading causes of death in the US. As recent research suggested that epilepsy, psychiatric disorders and suicide might be linked, CDC researchers used data from the 2003-2011 US National Violent Death Reporting System (NVDRS), a large multiple-state surveillance system that collects information on violent deaths including suicide, to find out how often and in which conditions suicide occurs among epilepsy patients. The resulting report is the first state-based study in the US to examine the suicide rate and suicide risk factors among people with epilepsy.

Between 2003 and 2011, an average of 17 out of 100,000 people with epilepsy, aged 10 years and older, died from suicide each year, compared to 14 out of 100,000 in the general population. Among adults aged 40-49 years, those with epilepsy died more often from suicide (29%) than those without epilepsy (22%). The authors looked at additional factors such as race/ethnicity, education, and marital status, which overall did not differ between those with and without epilepsy who died from suicide. However, it is important to note that in both groups about one-third of the suicides occurred among those with the least education.

The study also revealed that people with epilepsy were more likely to commit suicide in residential settings (81%), compared to those without the disorder (76%). This is important to highlight, because more suicides in people with epilepsy resulted from poisoning. As a result, it may be beneficial to have caregivers, relatives, and others in the home of epilepsy patients with a prior suicide risk supervise the availability of potentially harmful materials.

“The suicide rate is higher among people with epilepsy compared to the general population, so suicide prevention efforts are urgently needed to prevent these deaths,” said Dr Rosemarie Kobau, health scientist in CDC’s division of population health and a co-author on the report. “Caregivers of people with epilepsy and other members of the public can participate in programmes such as Mental Health First Aid, an evidence-based program available in many US communities that teaches people about mental illness symptoms, and how to recognise and intervene during a mental health crisis.”

Objective: This study analyzed suicide data in the general population from the US National Violent Death Reporting System (NVDRS) to investigate suicide burden among those with epilepsy and risk factors associated with suicide and to suggest measures to prevent suicide among people with epilepsy.
Methods: The NVDRS is a multiple-state, population-based, active surveillance system that collects information on violent deaths including suicide. Among people 10 years old and older, we identified 972 suicide cases with epilepsy and 81,529 suicide cases without epilepsy in 17 states from 2003 through 2011. We estimated their suicide rates, evaluated suicide risk among people with epilepsy, and investigated suicide risk factors specific to epilepsy by comparing those with and without epilepsy. In 16 of the 17 states providing continual data from 2005 through 2011, we also compared suicide trends in people with epilepsy (n = 833) and without epilepsy (n = 68,662).
Results: From 2003 through 2011, the estimated annual suicide mortality rate among people with epilepsy was 16.89/100,000 per persons, 22% higher than that in the general population. Compared with those without epilepsy, those with epilepsy were more likely to have died from suicide in houses, apartments, or residential institutions (81% vs. 76%, respectively) and were twice as likely to poison themselves (38% vs. 17%) (P < 0.01). More of those with epilepsy aged 40–49 died from suicide than comparably aged persons without epilepsy (29% vs. 22%) (P < 0.01). The proportion of suicides among those with epilepsy increased steadily from 2005 through 2010, peaking significantly in 2010 before falling.
Significance: For the first time, the suicide rate among people with epilepsy in a large U.S. general population was estimated, and the suicide risk exceeded that in the general population. Suicide prevention efforts should target people with epilepsy 40–49 years old. Additional preventive efforts include reducing the availability or exposure to poisons, especially at home, and supporting other evidence-based programs to reduce mental illness comorbidity associated with suicide.

Niu Tian, Wanjun Cui, Matthew Zack, Rosemarie Kobau, Katherine A Fowler, Dale C Hesdorffer

Elsevier Life Sciences material
Epilepsy & Behaviour abstract

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