Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, People's Republic of China.
West China Medical School, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan, People's Republic of China.
Sci Rep. 2021 Feb 2;11(1):2742. doi: 10.1038/s41598-021-81870-9.
People with epilepsy (PWE) have an increased suicide prevalence. This study aimed to identify the risk factors for suicidal tendency among PWE in West China. A nested case-control study was designed in a cohort of patients with epilepsy (n = 2087). In total, 28 variates were calculated. In the univariate analysis, unemployment, low income, seizure frequency, seizure-free time, infectious or structural etiology, levetiracetam or phenobarbital use, anxiety, depression, and stigma were associated with suicidal tendency. A multivariate analysis indicated that unemployment (odds ratio [OR] 5.74, 95% confidence interval [CI] 2.13-15.48), levetiracetam use (OR 2.80, 95%CI 1.11-7.05), depression (C-NDDI-E score ≥ 13; OR 3.21, 95%CI 1.26-8.21), and stigma (SSCI score ≥ 16; OR 6.67, 95%CI 1.80-24.69) were independently associated with suicidal tendency. Conditional inference tree analysis indicated that SSCI and C-NDDI-E scores could effectively identify patients with suicidal tendency. Thus, this study suggests that unemployment, levetiracetam use, depression, and stigma are independent risk factors for suicidal tendency in PWE in China.
癫痫患者（PWE）的自杀率较高。本研究旨在确定中国西部 PWE 自杀倾向的危险因素。设计了一项癫痫患者队列的巢式病例对照研究（n=2087）。共计算了 28 个变量。单因素分析表明，失业、低收入、发作频率、无发作时间、感染或结构病因、左乙拉西坦或苯巴比妥的使用、焦虑、抑郁和耻辱感与自杀倾向有关。多因素分析表明，失业（优势比 [OR] 5.74，95%置信区间 [CI] 2.13-15.48）、左乙拉西坦的使用（OR 2.80，95%CI 1.11-7.05）、抑郁（C-NDDI-E 评分≥13；OR 3.21，95%CI 1.26-8.21）和耻辱感（SSCI 评分≥16；OR 6.67，95%CI 1.80-24.69）与自杀倾向独立相关。条件推断树分析表明，SSCI 和 C-NDDI-E 评分可有效识别有自杀倾向的患者。因此，本研究表明，失业、左乙拉西坦的使用、抑郁和耻辱感是中国 PWE 自杀倾向的独立危险因素。
