Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, NO.1 Yixueyuan Rd. Yuzhong District, 400016, Chongqing, China.
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, NO.1 Yixueyuan Rd. Yuzhong District, 400016, Chongqing, China.
Epilepsy Res. 2020 Feb;160:106265. doi: 10.1016/j.eplepsyres.2020.106265. Epub 2020 Jan 3.
The highest risk of suicide was identified among patients diagnosed with both epilepsy and comorbid psychiatric disease. The most common comorbid psychiatric conditions of epilepsy are anxiety and depression. This study examines whether and how seizure frequency, depression and generalized anxiety interact to influence suicidal tendency.
A consecutive cohort of PWE was recruited from the First Affiliated Hospital of Chongqing Medical University. Each patient completed the Neurological Disorders Depression Inventory for Epilepsy scale[NDDI-E], the Generalized Anxiety Disorder-7 (GAD-7), and the suicidality module of Mini-International Neuropsychiatric Interview(MINI) v.5.0.0. Spearman's correlation and moderated mediation analysis were used to examine the associations among seizure frequency, depression, generalized anxiety and suicidal tendency.
Seizure frequency was positively associated with suicidal tendency. Depression severity partially mediated the relationship between seizure frequency and suicidal tendency. The indirect effect of seizure frequency on suicidal tendency was positive, and accounted for 50.2 % of the total effect of seizure frequency on suicidal tendency. The indirect effect of seizure frequency on suicidal tendency through depression severity was positively moderated by generalized anxiety severity.
Reducing seizure frequency may be the basis of suicide prevention in PWE. At the same time, the effect of seizure frequency on suicidal tendency can be partially explained by the mediation of depression severity, and the magnitude of the indirect effect of seizure frequency on suicidal tendency was contingent upon generalized anxiety severity. In addition to depression severity, generalized anxiety severity also exerts an important effect on suicidal tendency in PWE.
癫痫合并共病精神疾病患者自杀风险最高。癫痫最常见的共病精神疾病是焦虑和抑郁。本研究旨在探讨癫痫发作频率、抑郁和广泛性焦虑是否以及如何相互作用影响自杀倾向。
连续招募了来自重庆医科大学第一附属医院的 PWE 患者。每位患者均完成了神经障碍抑郁量表用于癫痫[NDDI-E]、广泛性焦虑障碍 7 项量表（GAD-7）和迷你国际神经精神访谈（MINI）第 5.0 版的自杀模块。Spearman 相关分析和调节中介分析用于检验癫痫发作频率、抑郁、广泛性焦虑和自杀倾向之间的关系。
癫痫发作频率与自杀倾向呈正相关。抑郁严重程度部分中介了癫痫发作频率与自杀倾向之间的关系。癫痫发作频率对自杀倾向的间接效应为正，占癫痫发作频率对自杀倾向总效应的 50.2%。癫痫发作频率通过抑郁严重程度对自杀倾向的间接效应被广泛性焦虑严重程度正向调节。
降低癫痫发作频率可能是预防 PWE 自杀的基础。同时，癫痫发作频率对自杀倾向的影响可以部分通过抑郁严重程度来解释，而癫痫发作频率对自杀倾向的间接效应的大小取决于广泛性焦虑严重程度。除了抑郁严重程度外，广泛性焦虑严重程度对 PWE 的自杀倾向也有重要影响。
