Abstracts

Rationale: The FDA warned that antiepilepsy medications (AEDs) increase the risk of suicidal ideation and behavior among people with epilepsy (FDA, December, 2008). However, little is known regarding risk factors for suicidality in children with epilepsy. In this study, we investigated the role of seizure related variables, including AEDs and seizure frequency, as well as psychiatric disorders, cognition (achievement, IQ), and language in children with chronic epilepsy who reported suicidal ideation and/or plan. Methods: This study included 177 children with chronic epilepsy and 97 healthy children aged 6-14 years. The evaluation included: Wechsler Intelligence Scale for Children-III (WISC-III), Wechsler Individual Achievement Test (WIAT-II), and Test of Language Development (TOLD-2). Children completed the Child Depression Inventory (CDI) and Multidimensional Anxiety Scale for Children (MASC). Children and parents participated in the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) psychiatric interview. Parents completed the Child Behavior Checklist (CBCL). Children with epilepsy and controls were compared on rates of suicidality. Among children with epilepsy, we compared DSM-IV psychiatric diagnoses, CBCL, MASC, and CDI, as well as demographic, seizure related variables, cognitive, achievement, and linguistic variables in those with and without suicidality. Results: 36 (20.3%) children with epilepsy reported suicidal ideation and/or plan compared to only 8 (8.26%) in the control group (p=.0216). Of the 36 children with suicidal ideation 11 (30.56%) had a plan (p>.0001). Children with a longer duration of epilepsy (p=0.005) were more likely to report suicidality. Other seizure variables, including number and type of AEDs, were not significantly different in those with and without suicidality. In addition, children with epilepsy with suicidality were older (p=0.007), had more psychiatric diagnoses (p=0.0064), including both disruptive and affective/anxiety disorders (p=.004), as well as higher CDI (p=0.001) and MASC (p=0.03) total scores. Elevated scores across the CBCL scales were also significantly higher in the suicidal subgroup, including Total (p<0.0001), Internalizing (p=0.0008), Externalizing (p=0.04), Withdrawn (p<.0001), Anxious/Depressed (p<.0001), Social Problems (p=.0009), Thought Problems (p<.0001), Attention Problems (p=0034), and Delinquent Behavior (p=.0002). However, there were no significant differences in gender, socioeconomic status, ethnicity, IQ, TOLD-2 or WIAT-II between subgoups.