Suicide rate among people with epilepsy is 22 per cent greater than the general population

The suicide rate among people with epilepsy has been found to be 22 per cent higher than in the general population in a study by the Centers for Disease Control and Prevention (CDC) in the United States.

The study was based on recent research that suggested that epilepsy, psychiatric disorders and suicide might be linked. 

CDC researchers used data from the 2003-2011 US National Violent Death Reporting System (NVDRS), a database that collects information on violent deaths including suicide, to find out how often suicide occurs among people with epilepsy, and under what circumstances.

CDC report

The CDC report is the first state-based study in the United States to cover suicide rate and risk factors among people with epilepsy.

Suicide is one of the leading causes of death in the United States.  Between 2003 and 2011, an average of 17 out of 100,000 people with epilepsy, aged 10 years and older, died from suicide each year, compared with 14 out of 100,000 in the general population. Among adults aged 40-49 years, those with epilepsy died more often from suicide (29 per cent) than those without epilepsy (22 per cent).

Additional factors

The study authors examined additional factors such as ethnicity, education, and marital status, which overall did not differ between those with and without epilepsy who died from suicide.

In both groups about one third of the suicides occurred among those with the least education.

Suicides in residential settings

The study, published in Epilepsy & Behavior, also revealed that people with epilepsy were more likely to take their own lives in residential settings (81 per cent), compared to those without the condition (76 per cent).

The study found that more suicides in people with epilepsy were caused by poisoning, a factor that could be reduced by raising awareness of the risks of harmful substances among relatives and staff in a care setting.

Comment

The report's co-author, Rosemarie Kobau, MPH, MAPP, said: "The suicide rate is higher among people with epilepsy compared to the general population, so suicide prevention efforts are urgently needed to prevent these deaths.

"Caregivers of people with epilepsy and other members of the public can participate in programmes such as Mental Health First Aid, an evidence-based programme available in many US communities that teaches people about mental illness symptoms, and how to recognise and intervene during a mental health crisis."

Epilepsy Society suicide review

In 2009 Epilepsy Society's Dr Gail Bell and Professor Ley Sander conducted a review of epilepsy and suicide.

Their review found that people with epilepsy may have undiagnosed and untreated psychiatric illness, and that depression (both reactive and endogenous) may occur.  Studies have suggested that the relationship between seizures and depression or suicidal behaviour may be bidirectional, and that both major depression and attempted suicide increase the risk of developing seizures. 

In people with epilepsy, both with and without accompanying psychiatric disease, the risk of suicide was highest in the first six months after diagnosis.

A questionnaire study from Canada found that lifetime prevalence of suicidal ideation in people with epilepsy (25 per cent) was higher than in people without epilepsy (13 per cent).

Reasons for suicide in people with epilepsy

It was suggested almost 30 years ago that an important reason for the high risk of suicide in people with epilepsy might be social disadvantages, and psychiatric disturbance and the use of antiepileptic drugs (AEDs) might play a role. It was suggested that reducing stigma, as well as seeking and treating psychiatric symptoms in people with epilepsy and treating seizures with the smallest effective dose of AEDs, could be important in suicide prevention.

Conclusion

The review concludes: " It seems conclusive that the risk of suicide is increased in people with epilepsy, but further studies are needed to identify those more at risk. Claims have been made that suitable treatment may prevent suicides in people with epilepsy and dysphoric disorders, but these need to be substantiated."

Read the review by Ley Sander and Gail Bell in full here.

Epilepsy helpline 

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Call: 01494 601 400 (national call rate) Daytime: Monday, Tuesday, Thursday and Friday 9am - 4pm Extended hours: Wednesday: 9am - 8pm Email: helpline@epilepsysociety.org.uk

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