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我宁愿死:调查癫痫患者的自杀意念。

I would be better off dead: investigating suicidal ideation in people with epilepsy.

机构信息

Pontifícia Universidade Católica de Campinas, Programa de Pós-Graduação em Ciências da Saúde, Campinas SP, Brazil.

Pontifícia Universidade Católica de Campinas, Faculdade de Medicina, Campinas SP, Brazil.

出版信息

Arq Neuropsiquiatr. 2022 Jul;80(7):718-724. doi: 10.1055/s-0042-1755230. Epub 2022 Sep 29.

Abstract

BACKGROUND

It is known that the risk of suicidal behavior in adult people with epilepsy (PWEs) is high. However, the associated clinical and psychosocial factors are still being discussed.

OBJECTIVE

To assess the risk of suicide in PWEs and relate it to resilience and quality of life (QoL) as well as with clinical variables.

METHODS

The item "I'd be better off dead" of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was related to the resilience scale, clinical aspects, the presence of depression, and the Quality of Life in Epilepsy Inventory (QOLIE-31) scores of PWEs, with a  < 0.05.

RESULTS

A total of 271 PWEs were assessed, 50.6% were female, with a mean age of 46.6 (± 15.8) years, and a mean age at 1st seizure of 24.1 (± 18.5) years. Risk for suicide occurred in 50 (19.3%) cases. In multiple logistic regression, the factors that explain the risk of suicide were female sex, depression, and lower scores on the QOLIE-31 and on the resilience scale. In the classification and regression trees, the order of importance of the variables was depression > resilience > age > QoL > age at 1st seizure.

CONCLUSION

The risk of suicide was high, and it was associated with demographic aspects, clinical variables, QoL, and resilience. A higher risk of suicide was associated with lower resilience regardless of the presence or absence of depression. In the presence of depression, a higher risk of suicide was associated with the early onset of epilepsy. In the absence of depression, the risk of suicide was associated with low QoL in young adults.

摘要

背景

已知成年人癫痫患者(PWE)自杀行为的风险较高。然而,相关的临床和社会心理因素仍在讨论中。

目的

评估 PWE 自杀风险,并将其与韧性和生活质量(QoL)以及临床变量相关联。

方法

使用癫痫神经障碍抑郁量表(NDDI-E)中的“我宁愿死”项,将其与韧性量表、临床方面、抑郁存在情况以及癫痫患者生活质量量表(QOLIE-31)评分相关联,P 值<0.05。

结果

共评估了 271 名 PWE,其中 50.6%为女性,平均年龄为 46.6(±15.8)岁,首次发作的平均年龄为 24.1(±18.5)岁。有 50 例(19.3%)出现自杀风险。在多因素逻辑回归中,解释自杀风险的因素为女性、抑郁以及 QOLIE-31 和韧性量表评分较低。在分类回归树中,变量的重要性顺序为抑郁>韧性>年龄>QoL>首次发作年龄。

结论

自杀风险较高,与人口统计学方面、临床变量、QoL 和韧性有关。无论是否存在抑郁,韧性较低与自杀风险增加相关。在存在抑郁的情况下,癫痫早期发作与自杀风险增加相关。在没有抑郁的情况下,自杀风险与年轻成年人的低 QoL 相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6a3/9685829/11becde9065e/1678-4227-ANP-80-07-0718-gf01.jpg

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