Abstract, published in Epilepsia
Objectives: Studies in adult epilepsy patients have shown higher rates of suicidal ideation and attempt, but similar studies in children are limited. Using the Rochester Epidemiology Project (REP) database, we compared the risk of self-injurious behavior and suicidal ideation in a population-based cohort of childhood epilepsy to controls. The REP is a collaboration of clinics, hospitals, and other medical facilities in Minnesota and Wisconsin and involves community members who have agreed to share their medical records for research.
Methods: Researchers studied 339 cases with epilepsy and 678 age- and sex-matched controls followed to an average age of 24.7 and 23.4 years, respectively, and identified 98 subjects with self-injurious behavior or suicidal ideation (43 with epilepsy and 55 controls). All behaviors were categorized using the Columbia Suicide Severity Rating Scale, which is a standard measure used to identify and assess individuals at risk for suicide
Results: Those with epilepsy had a significantly higher rate of any self-injurious behavior and suicidal ideation and tended to have an increased risk of suicidal ideation and attempt. The prevalence of preceding mood and substance abuse disorders was similarly high in both cases and controls with self-injurious behavior or suicidal ideation; however, preceding attention-deficit/hyperactivity disorder was more than twice as common in the epilepsy cases. Among cases with epilepsy, we did not identify any specific epilepsy-related variable that was significantly correlated with risk of self-injurious behavior or suicidal ideation.
Significance: Children, teens, and young adults with a history of childhood epilepsy are at greater risk of self-injurious behavior, highlighting the need for careful screening of mental health concerns as part of routine epilepsy care.