Abstracts

Rationale: Suicide is the third most common cause of death in children and youths (Galaif, 2007). Patients with epilepsy and psychogenic nonepileptic seizures (PNES) have an increased prevalence of psychiatric illness and risk for suicidal ideation/suicidal behavior/suicide compared with the general population (Kaufman, 2010). Less is known about attempted suicide and whether psychiatric disorders and antiepileptic drugs modify the risk of attempted suicide in children and adolescents with PNES.   Methods: We evaluated children with PNES documented by video electroencephalography. None had a previous diagnosis of PNES. In total, we included 63 children (interquartile range: seven to 17 years; mean age 12.53 years [S.D. 3.31]; 60% girls). The diagnosis of co-existing psychiatric disorders was made through a psychiatric interview followed by the Schedule for Affective Disorders and Schizophrenia for School-Age Children—Epidemiological Version (KIDDIE-SADS). Suicidality was inquired to patients and caregivers in more than one interview. Results: Seven patients (11.11%) had attempted suicide. Patients who had been abused physically or sexually were more likely to attempt suicide (p<0.005).Mean age of the patients that attempted suicide was 16.0, while the rest of the patients had a mean age of 12.1 (p<0.001).Two patients attempted in more than one occasion. The presence of co-existing depression was statistically significantly higher in the attempted suicide group (<0.001), but co-existence of anxiety, psychosis, or bipolar mood disorders did not differ between the two groups.  Conclusions: The risk of attempted suicide in children and adolescents with PNES is high. Children who suffered abuse, older children, and children with depression may be at higher risk for suicidality. Given the recurrence of suicide attempts documented in this population, as in others, intensified efforts are mandatory as life-saving measures for these children. Funding: No funding