Mendez M F, Lanska D J, Manon-Espaillat R, Burnstine T H
Department of Neurology, University Hospitals of Cleveland, Ohio.
Arch Neurol. 1989 Oct;46(10):1065-8. doi: 10.1001/archneur.1989.00520460041011.
We investigated possible causative factors for the high epileptic suicide rate by reviewing the cases of 22 patients with idiopathic epilepsy found among 711 patients hospitalized for a suicide attempt by overdose. Suicide attempts occurred with increased seizure activity in one epileptic; otherwise, no relationships were found with seizure-related variables. When matched by age, sex, and race with 44 nonepileptic controls from the same population, the epileptics had more borderline personality disorders with multiple impulsive suicide attempts (45.5% vs 13.6%), more psychotic disturbances, including command hallucinations (31.8% vs 9.1%), fewer adjustment disorders (18.2% vs 45.5%), and a comparable frequency of depression (13.6% vs 25%). We conclude that suicide attempts in epileptics are primarily associated with interictal psychopathologic factors, such as borderline personality disorder and psychosis, rather than with specific psychosocial stressors, seizure variables, or anticonvulsant medications.
我们通过回顾711例因过量服药自杀未遂而住院的患者中发现的22例特发性癫痫患者的病例，调查了癫痫患者自杀率高的可能致病因素。一名癫痫患者的自杀未遂与癫痫发作活动增加有关；否则，未发现与癫痫相关变量存在关联。当按年龄、性别和种族与来自同一人群的44名非癫痫对照进行匹配时，癫痫患者有更多伴有多次冲动性自杀未遂的边缘性人格障碍（45.5%对13.6%）、更多的精神障碍，包括命令性幻听（31.8%对9.1%）、更少的适应障碍（18.2%对45.5%），以及相当的抑郁频率（13.6%对25%）。我们得出结论，癫痫患者的自杀未遂主要与发作间期的心理病理因素有关，如边缘性人格障碍和精神病，而非特定的社会心理应激源、癫痫变量或抗惊厥药物。
