Abstracts

Recent epidemiological studies indicate that suicide is a major cause of death in persons with epilepsy. Suicide risk appears to be greater in persons with epilepsy than that in general population. The increased prevalence of depression in epilepsy is presumably associated with the increased suicide risk, but this has not been systematically studied. We performed a prospective study of a large sample of epilepsy outpatients to evaluate their recent suicidal ideation. We evaluated 193 consecutive consenting adult epilepsy patients over a two-year period in a tertiary epilepsy clinic. In addition to clinical variables, Beck Depression Inventory (BDI), Adverse Events Profile (AEP) and QOLIE-89 scores were obtained. Question 9 of the BDI was used to categorize patients into two groups based on presence or absence of suicidal ideation in the prior two weeks. Between-group differences for clinical variables and for the BDI, AEP and QOLIE-89 total scores were compared using Student[apos]s t-test. Chi-square test was used to calculate group comparisons, and a Mann-Whitney U test for independent groups comparison. A value of p[lt] 0.05 was considered significant. We found that 11.9% (23 of 193) of our patients had suicidal thoughts during previous two weeks. Although the BDI, AEP and QOLIE-89 scores were significantly different between the two groups, suicidal ideation was not predicted by AEP scores, QOLIE total scores, patients[apos] age or gender, social and vocational status, seizure frequency, localization of seizure focus, seizure type, or number of AEDs. Further, we showed that 26% (6 of 23) of epilepsy outpatients with suicidal ideation scored in the normal to minimally depressed range (total BDI score of less than 15). In our epilepsy outpatient cohort, 38.4% of patients had at least mild depressive symptoms and a frequency of suicidal ideas increased with severity of depressive symptoms. Every 8^th to 9^th epilepsy patient in a tertiary epilepsy clinic may have had suicidal ideation during prior two weeks. Nearly one-third of these patients will score in the euthymic to mildly depressed range on depression screening instruments. However, clinical depression remains the strongest predictor of suicidal risk when compared to quality of life or medication toxicity. (Supported by NIH grants NS01794 and NS40808 (F.G.), and the Epilepsy Foundation of America (H.H.).)