Abstracts

Rationale: Compared to the general population, persons with epilepsy (PWE) have higher rates of suicidal ideation and are more likely to die by suicide. Factors leading to SI include psychiatric comorbidity, postictal psychosis, cognitive impairment, seizure type, age of onset, epilepsy surgery, and psychosocial circumstances. Up to now, studies investigating suicidality in PWE have been limited by lack of longitudinal data, therefore the factors leading to changes in suicidal ideation in this population are not well established. Our aim is to identify risk factors over time that may predict increasing suicidal ideation and how this progresses to suicide attempts. Methods: We prospectively collected electronic questionnaires surveying quality of life, mood and depressive symptoms, demographic and social information, seizure frequency, and recent suicidal ideation. Objective clinical data (i.e., medication changes, epilepsy surgery) were documented at each time point. The prevalence of death by suicide is to be extracted from cause-of-death data, and risk factors for completed suicide were explored. Results: Data was collected on 3,429 patients with diagnosis of epilepsy seen between 2013 and 2016, with 2.7% of patients dying during these 4 years. Longitudinal data is available for 1516 of these cases (3 or more visits). Thirty eight percent (n=1255) of the sample reported a score of 15 or greater on the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). The rate of any suicidal ideation at one or more clinic visit was 25% (n=854). The degree of suicidal ideation was correlated with risk of death (no SI, 2.5% mortality; any SI, 6.6% mortality; frequent SI only, 11% mortality.) Conclusions: Depression and suicidal ideation are highly prevalent in this patient population, and increased frequency of suicidal thoughts is predictive for higher mortality. Future directions will focus on whether suicidal ideation is correlated with changes in other self-reported factors such as depression, quality of life, insomnia, aggression, and seizure frequency. Further analysis, including cause of death data collection, is ongoing, and will examine both suicidal ideation and completed suicide.