Abstracts

Pediatric epilepsy patients are at high risk for the development of depression. Few studies exist to explore occurrence of suicidal ideations (SI) for pediatric patients with epileptic seizures (ES). Furthermore, the limited data available on pediatric patients with psychogenic nonepileptic seizures (PNES) suggests complex psychiatric presentations that would lend to an even higher risk for SI. The objective of the present investigation is to describe incidence of SI in patients with ES, PNES, and a mix of both ES and PNES (MIX) among children hospitalized for evaluation of seizures. Records of 267 pediatric patients formerly diagnosed with ES, PNES, or MIX events who were admitted to an inpatient epilepsy unit from 09/99 through 04/05 for video-EEG monitoring to clarify seizures were retrospectively reviewed. Patients were included if they were formally evaluated by a pediatric psychologist during the hospitalization and if ES, PNES or MIX was diagnosed by a pediatric neurologist. Patients with physiological nonepileptic events were excluded from analysis. For this study, all epileptic seizure types were considered together and any report of past or current suicidal thoughts was considered as an endorsement of suicidal ideation (SI). Of the 267 participants, 46% were male and 54% were female; 75% (N=200) of patients had ES, 16% (N=43) had only PNESs, and 9% (N=24) had MIX. Patients with ES were significantly younger (mean=10 yrs; p[lt].001) than patients with PNES (mean=13 yrs) and patients with MIX (mean=13.5 yrs). Overall, 15% (N=39) of the patients in this study reported a history of SI. This includes 26% of patients diagnosed with PNES (N=11), 38% of MIX patients (N=9), and 10% of ES (N=19). Chi-square analyses revealed that both PNES and MIX groups were significantly more likely to report SI than those with ES (p[lt].003 and p[lt].001, respectively). SI reports for patients with PNES only were not significantly different than those with MIX. Patients diagnosed with PNES or MIX events were significantly more likely to report SI than those diagnosed solely with ES. Pediatric patients with MIX were no different from those with only PNES with respect to SI. This warrants further investigation into the mediating factors increasing the risk of SI for children with PNES.