Abstracts

Rationale: People with epilepsy (PWE) and Psychogenic Nonepileptic Events (PNES) have a high prevalence of psychiatric disorders and suicidality, with an increased suicide risk of up to 5-fold. Suicide ideation is reported by 10% of patients with PWE, 25% of patients with PNES and almost 40% of patients with both conditions. Multiple factors seem to be related to this high risk of suicide, such as: the presence of psychiatric disorder, the use of anti-epileptic drugs, social  factors, etc. Because of its complexity, there is little data on literature regarding suicidality and its predictors. The objective of this study was to describe suicidal ideations and suicidal attempts in a sample of Brazilian patients with PNES, PWE and both conditions (MIX), and its potential risk factors.  Methods: We prospectively interviewed 152 patients patients followed in two tertiary epilepsy centers, divided in three groups: PWE (63 patients; mean age 38.2; 65% female), PNES (55 patients; mean age 35.4; 74.5% gender) and PNES and PWE (34 patients; mean age 36.5; 79.4% female). In the PWE and MIX groups were included only patients with TLE, regardless of the presence or absence of hippocampal sclerosis. PNES and MIX were only diagnosed after a video-EEG monitoring. Questionnaire about suicide addressed the Suicide Behavioral Disorder, as described by the DSM-V and comprised: suicide ideation, suicide planning, and suicide attempt. Suicide ideation was defined as feeling suicidal or having a strong desire of dying, on the past or current time. Suicide planning was defined as thinking on how one could commit suicide and having a clear plan to do so. Suicide attempt was defined as na actual attempt of suicide. Suicide communication and behavioral changes were not included. The patients underwent a psychiatric evaluation, as part of our protocol.Patient’s characteristics analyzed were demographic variabilities, psychiatric comorbidities, family history and use of AEDs. Results: Suicide ideation occurred in 33 patients (21.7%). Suicidal ideation, planning and attempt were significantly more frequent in patients with PNES. (Table 1)There was no significant difference betwenn the three groups regarding incidence of depression, anxiety, substance abuse or family history of epilepsy or psychiatric diseases.  Conclusions: Suicidal ideations were described by 21.7% of patients in two tertiary epilepsy centers. This high incidence highlights the need of a systematic approach to psychiatric comorbidities and suicidality in epilepsy centers, with special attention to patients with PNES.  Funding: None