Department of Neurosurgery, Hualien Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; College of Medicine, Tzu Chi University, Hualien, Taiwan.
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
J Affect Disord. 2018 Mar 15;229:79-84. doi: 10.1016/j.jad.2017.12.048. Epub 2017 Dec 29.
We would like to exam whether epilepsy patients in Taiwan have a high risk of attempted and completed suicide.
In this study, we used a subset of the National Health Insurance Research Database (NHIRD) of Taiwan. Inpatients (≥ 18 years) who received a new diagnosis of epilepsy between 2000 and 2011 were enrolled in the epilepsy cohort. The epilepsy and comparison cohorts included 68,543 patients and 2-fold controls respectively. We calculated the adjusted hazard ratio (aHR) for suicide attempts after adjustment for age, sex, monthly income, the urbanization level, occupation, and comorbidity.
The epilepsy cohort had a 2.06-fold risk of suicide attempts (95% CI = 1.65-2.56) compared with the control cohort. The suicide attempt risk did not significantly differ between men and women and between patients with and without psychiatric comorbidity. The mortality risk after a suicide attempt was higher in the epilepsy cohort than in the comparison cohort (aHR = 1.66, 95% CI = 1.02-2.69).
Epilepsy is an independent and predisposing factor for suicide attempt. These results provide important information for clinicians and governments to prevent suicide in epilepsy patients in Asian countries.
我们希望考察台湾地区癫痫患者自杀未遂和自杀死亡的风险是否较高。
本研究使用了台湾全民健康保险研究数据库（NHIRD）的一个子集。2000 年至 2011 年间，新诊断为癫痫的住院患者（≥18 岁）被纳入癫痫队列。癫痫队列和对照组分别纳入了 68543 例患者和 2 倍的对照。我们计算了自杀未遂的校正后风险比（aHR），并对年龄、性别、月收入、城市化水平、职业和合并症进行了校正。
与对照组相比，癫痫队列自杀未遂的风险高 2.06 倍（95%CI=1.65-2.56）。男性和女性、伴或不伴精神科合并症的患者之间，自杀未遂的风险无显著差异。与对照组相比，癫痫队列自杀未遂后的死亡率更高（aHR=1.66，95%CI=1.02-2.69）。
癫痫是自杀未遂的独立危险因素。这些结果为亚洲国家的临床医生和政府预防癫痫患者自杀提供了重要信息。
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