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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(07): 718-724
DOI: 10.1055/s-0042-1755230
Article

I would be better off dead: investigating suicidal ideation in people with epilepsy

Eu preferiria estar morto: avaliando a ideação suicida em pessoas com epilepsia
Gloria Maria de Almeida Souza Tedrus 
1   Pontifícia Universidade Católica de Campinas, Programa de Pós-Graduação em Ciências da Saúde, Campinas SP, Brazil.
,
Daniela de Carvalho Mendonça de Souza 
2   Pontifícia Universidade Católica de Campinas, Faculdade de Medicina, Campinas SP, Brazil.
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Abstract

Background It is known that the risk of suicidal behavior in adult people with epilepsy (PWEs) is high. However, the associated clinical and psychosocial factors are still being discussed.

Objective To assess the risk of suicide in PWEs and relate it to resilience and quality of life (QoL) as well as with clinical variables.

Methods The item “I'd be better off dead” of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was related to the resilience scale, clinical aspects, the presence of depression, and the Quality of Life in Epilepsy Inventory (QOLIE-31) scores of PWEs, with a p < 0.05.

Results A total of 271 PWEs were assessed, 50.6% were female, with a mean age of 46.6 (± 15.8) years, and a mean age at 1st seizure of 24.1 (± 18.5) years. Risk for suicide occurred in 50 (19.3%) cases. In multiple logistic regression, the factors that explain the risk of suicide were female sex, depression, and lower scores on the QOLIE-31 and on the resilience scale. In the classification and regression trees, the order of importance of the variables was depression > resilience > age > QoL > age at 1st seizure.

Conclusion The risk of suicide was high, and it was associated with demographic aspects, clinical variables, QoL, and resilience. A higher risk of suicide was associated with lower resilience regardless of the presence or absence of depression. In the presence of depression, a higher risk of suicide was associated with the early onset of epilepsy. In the absence of depression, the risk of suicide was associated with low QoL in young adults.

Resumo

Antecedentes É sabido que o risco de comportamento suicida é elevado em pessoas adultas com epilepsia (PCEs); entretanto, ainda são discutidos quais são os fatores clínicos e psicossociais associados.

Objetivo Avaliar o risco de suicídio em PCEs e relacioná-lo com a resiliência e a qualidade de vida (QV) e com as variáveis clínicas.

Métodos Foi relacionado o item – “Eu preferiria estar morto” do inventário de depressão em transtornos neurológicos para a epilepsia (IDTN-E) com a escala de resiliência, os aspectos clínicos, a presença de depressão e com o inventário de qualidade de vida na epilepsia (QOLIE-31) de PCEs, com p < 0.05.

Resultados Foram avaliados 271 PCEs, 50.6% dos quais eram do sexo feminino. A idade média foi de 46.6 (± 15.8) anos, e idade na 1ª crise 24.1 (± 18.5) anos. O risco de suicídio ocorreu em 50 (19.3%) casos. Na regressão logística múltipla, os fatores que explicaram o maior risco de suicídio foram o sexo feminino, a depressão, e os menores escores no QOLIE–31 e na escala de resiliência. Na árvore de classificação e regressão, a ordem de importância das variáveis foi depressão > resiliência > idade > QV > idade na 1ª crise.

Conclusão O risco de suicídio foi elevado e associou-se com aspectos demográficos, variáveis clínicas, a QV e a resiliência. O maior risco de suicídio associou-se à menor resiliência, independente da presença de depressão. Na presença de depressão, o maior risco de suicídio associou-se ao início precoce da epilepsia. Na ausência de depressão, o risco de suicídio associou-se à baixa QV em adultos jovens.

Keywords

Epilepsy - Suicide - Resilience, Psychological - Quality of Life

Palavras-chave

Epilepsia - Suicídio - Resiliência Psicológica - Qualidade de Vida

Authors' Contributions

GMAST: is the lead author of the project; GMAST, DCMS: were responsible for the data collection and for writing the manuscript.


Support

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Daniela de Carvalho Mendonça de Souza received a scientific initiation grant from the CNPq.




Publication History

Received: 15 October 2021

Accepted: 12 December 2021

Article published online:
29 September 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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