Neurocenter, Zagreb, Croatia.
University North, Varaždin, Croatia.
Curr Top Behav Neurosci. 2022;55:209-250. doi: 10.1007/7854_2021_220.
Suicidality presents a major global health concern and its association with epilepsy has been suggested. The body of evidence is growing due to targeted epidemiological studies, genetic findings, and neuroimaging data, use of specific neuropsychiatric inventories, neuropsychological tests, and metabolic and immunological studies.Suicide tendencies and psychiatric comorbidity such as depression are not uncommon in chronic diseases, especially in epilepsy. Suicide is an important cause of death in epilepsy, and is usually underestimated. Persons with epilepsy have higher risk for suicide than healthy controls. It appears that some epilepsy types have stronger tendencies for suicide, in particular temporal lobe epilepsy. The suicidal risk factors in persons with epilepsy include difficult to treat epilepsies, onset of epilepsy at an earlier age, and comorbid depression.This clinical evidence is mostly based on observational studies in which we found an increased risk of suicidal ideation, suicidal attempts, and completed suicides in persons with epilepsy. However, we lack prospective and longitudinal studies on suicide in epilepsy. In this chapter we will examine recent research in neurobiological mechanisms between suicidality and epilepsy, and comorbid depression.
自杀行为是一个全球性的主要健康问题，有人提出其与癫痫之间存在关联。由于目标明确的流行病学研究、遗传发现和神经影像学数据、特定神经精神学量表的使用、神经心理学测试以及代谢和免疫学研究，证据不断增加。在慢性疾病中，尤其是在癫痫中，自杀倾向和精神共病如抑郁症并不少见。自杀是癫痫患者死亡的一个重要原因，而且通常被低估了。癫痫患者自杀的风险高于健康对照组。似乎某些癫痫类型更倾向于自杀，尤其是颞叶癫痫。癫痫患者的自杀危险因素包括治疗困难的癫痫、癫痫发病年龄较早以及并发抑郁症。
这种临床证据主要基于观察性研究，我们在这些研究中发现癫痫患者有更高的自杀意念、自杀企图和自杀死亡风险。然而，我们缺乏关于癫痫患者自杀的前瞻性和纵向研究。在这一章中，我们将研究自杀行为和癫痫之间以及并发抑郁症的神经生物学机制的最新研究。
