Neuropsychiatric Unit, Neurology Division, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Epilepsy Behav. 2011 Dec;22(4):745-9. doi: 10.1016/j.yebeh.2011.09.004. Epub 2011 Oct 21.
The aim of the work described here was to measure the role of psychopathological features, specifically impulsivity and depression, in suicidality in patients with temporal lobe epilepsy (TLE).
Neuropsychiatric evaluation of 66 outpatients with TLE was performed with the following instruments: a structured clinical interview (Mini International Neuropsychiatric Interview Plus), the Barratt Impulsiveness Scale, the Hamilton Anxiety Scale, the Beck Depression Inventory, and the Brief Psychiatric Rating Scale.
A current Axis I psychiatric diagnosis, mainly mood and anxiety disorders, was assigned to 37 subjects (56.1%) Presence of suicide risk was identified in 19 patients (28.8%), and 14 (21.2%) had attempted suicide. Frequency of seizures (P=0.012), current major depression (P=0.001), and motor impulsivity (P=0.005) were associated with suicide risk on univariate analysis. Logistic regression stressed the main relevance of major depression (OR=12.82, 95% CI=2.58-63.76, P=0.002) and motor impulsivity (OR=1.21, 95% CI=1.06-1.38, P=0.005) to suicide risk.
Depression has a major influence on suicidality in epilepsy. Motor impulsivity is also relevant and may be an important component of depression in TLE associated with suicide risk.
本研究旨在评估精神病理特征，特别是冲动性和抑郁，在颞叶癫痫（TLE）患者自杀中的作用。
对 66 例 TLE 门诊患者进行神经精神病学评估，使用以下工具：结构化临床访谈（MINI 国际神经精神访谈 Plus）、巴瑞特冲动量表、汉密尔顿焦虑量表、贝克抑郁量表和简明精神病评定量表。
37 名患者（56.1%）存在当前的轴 I 精神疾病诊断，主要为心境和焦虑障碍。19 名患者（28.8%）存在自杀风险，14 名患者（21.2%）曾尝试自杀。单因素分析显示，癫痫发作频率（P=0.012）、当前重度抑郁症（P=0.001）和运动冲动性（P=0.005）与自杀风险相关。逻辑回归强调了重度抑郁症（OR=12.82，95%CI=2.58-63.76，P=0.002）和运动冲动性（OR=1.21，95%CI=1.06-1.38，P=0.005）对自杀风险的主要相关性。
抑郁对癫痫患者的自杀行为有重大影响。运动冲动性也很重要，可能是与自杀风险相关的 TLE 中抑郁的一个重要组成部分。
