Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States.
Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States.
Epilepsy Behav. 2019 Oct;99:106421. doi: 10.1016/j.yebeh.2019.07.022. Epub 2019 Aug 2.
Suicide timing varies across several psychiatric disorders, which may share common underlying pathophysiological mechanisms with epilepsy. We investigated suicide timing in people with epilepsy. Using cross-sectional, population-based U.S. National Violent Death Reporting System data from 2003 through 2014 in 18 States, we identified 1310 suicides with epilepsy and 102,582 suicides without epilepsy among those 10 years and older. We compared patterns of suicide mortality ratios between those with and without epilepsy by month of year, week of month, day of week, time of day, and overall by age, sex, and race/ethnicity. As the suicide patterns seen among persons without epilepsy, suicides in persons with epilepsy occurred significantly more often during the morning, afternoon, and evening hours than at night in all subgroups except females. Compared to Sundays, suicides in persons with epilepsy were only significantly increased on Mondays and Tuesdays in those aged ≥45 years and only on Mondays in men. This pattern differs from persons without epilepsy whose suicides significantly increased on Mondays and significantly decreased on Saturdays in nearly all study subgroups. Suicides in persons with epilepsy did not exhibit the timing patterns of persons without epilepsy by week of month (significant decreases from the third to fifth weeks compared to the first week among those aged ≥45 years, males, and Non-Hispanic whites) and month of year (significant increases from January to November peaking from June to September compared to December in all study groups). Compared to the general population or people without epilepsy, previous and current studies suggest that in people with epilepsy, suicide timing differs from and suicide rates significantly exceed those in people without epilepsy. Preventing suicide in people with epilepsy should focus not only on the peak times of occurrence but also across all time periods.
自杀时间在几种精神疾病中有所不同，这些疾病可能与癫痫有共同的潜在病理生理机制。我们研究了癫痫患者的自杀时间。利用 2003 年至 2014 年美国 18 个州基于人群的国家暴力死亡报告系统的横断面数据，我们在 10 岁及以上人群中确定了 1310 例癫痫自杀和 102582 例非癫痫自杀。我们比较了癫痫患者和非癫痫患者在年、月、周、日、时和年龄、性别、种族/族裔的自杀死亡率模式。与非癫痫患者的自杀模式相似，癫痫患者的自杀发生在所有亚组中，除女性外，上午、下午和晚上的时间明显多于晚上。与周日相比，在≥45 岁的人群中，癫痫患者的自杀仅在周一和周二显著增加，而在男性中仅在周一显著增加。与非癫痫患者的自杀模式不同，非癫痫患者的自杀在几乎所有研究亚组中周一显著增加，周六显著减少。癫痫患者的自杀没有表现出非癫痫患者的月、周模式（与≥45 岁、男性和非西班牙裔白人的第一周相比，第四至第五周显著减少）和年模式（与所有研究组的 12 月相比，1 月至 11 月显著增加，6 月至 9 月达到峰值）。与一般人群或非癫痫患者相比，之前和目前的研究表明，在癫痫患者中，自杀时间与非癫痫患者不同，自杀率明显高于非癫痫患者。预防癫痫患者自杀不仅应关注发生的高峰时间，还应关注所有时间段。
