Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Seizure. 2019 Apr;67:65-70. doi: 10.1016/j.seizure.2019.03.013. Epub 2019 Mar 19.
Suicidality including suicidal ideation and attempt has been a critical issue in people with epilepsy, especially in people with drug-resistant epilepsy (PWDRE). Clinicians commonly ask about adverse effects of antiepileptic drugs (AEDs) using something like the Liverpool Adverse Events Profile (LAEP) at epilepsy clinics, but suicide is usually not of interest. A high risk of suicidality can increase mortality by committing suicide in PWDRE. This study aimed to investigate whether clinicians can discern a high risk of suicidality in PWDRE by referring to the LAEP.
We recruited PWDRE, aged from 19 to 68. They completed the 21-item LAEP, the suicidality module of the Mini International Neuropsychiatric Interview, and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Through receiver operating characteristic curve analysis, we tested the usefulness of LAEP to detect a high risk of suicide. By this, we determined each cutoff point of the total LAEP score and the number of severe LAEP items, for detecting the risk.
A hundred forty-four PWDRE participated in this study. Among them, 36 PWDRE (25.0%) had a high risk of suicidality. Either >45 of the total LAEP score or >8 of the number of severe LAEP items was a suggested optimal cutoff point for discerning the high risk of suicidality. LAEP had a correlation with the suicidality item of the NDDI-E.
The LAEP may inform a high risk of suicidality in PWDRE. Referring to this, clinicians can discern suicidal problems in their epilepsy clinics.
自杀意念和自杀企图一直是癫痫患者（尤其是耐药性癫痫患者）的一个严重问题。临床医生在癫痫诊所通常会使用利物浦不良事件量表（LAEP）等工具询问抗癫痫药物（AED）的不良反应，但通常不会关注自杀问题。自杀风险高可能会增加耐药性癫痫患者的死亡率。本研究旨在通过参考 LAEP 来调查临床医生是否能够识别耐药性癫痫患者的自杀高风险。
我们招募了年龄在 19 至 68 岁的耐药性癫痫患者。他们完成了 21 项 LAEP、迷你国际神经精神访谈中的自杀模块以及癫痫神经障碍抑郁量表（NDDI-E）。通过接受者操作特征曲线分析，我们测试了 LAEP 用于检测自杀高风险的有用性。通过这种方法，我们确定了 LAEP 总分和严重 LAEP 项目数的每个切点，以检测风险。
144 名耐药性癫痫患者参与了这项研究。其中，36 名患者（25.0%）有自杀高风险。LAEP 总分>45 或严重 LAEP 项目数>8 可能是识别自杀高风险的最佳切点。LAEP 与 NDDI-E 的自杀项目存在相关性。
LAEP 可能提示耐药性癫痫患者存在自杀高风险。临床医生可以通过参考 LAEP 来识别他们癫痫诊所中的自杀问题。
