Wang Haijiao, Zhang Yu, Tan Ge, Chen Deng, Fu Yaoqi, Liu Ling
Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha City, China.
Front Psychiatry. 2023 Mar 29;14:1097516. doi: 10.3389/fpsyt.2023.1097516. eCollection 2023.
We aimed to evaluate the association between epilepsy and suicidality, including suicidal ideation, attempts and completed suicide.
We systematically searched PubMed, Embase, Cochrane Online Library, and Clinicaltrials.gov from 1946 to June 21, 2021 and assessed the quality of the studies using the Newcastle-Ottawa Scale. We calculated the pooled OR and the crude rate for suicidal ideation, suicide attempts and completed suicide in patients with epilepsy (PWE).
We screened 2,786 studies and included 88 articles with 1,178,401 PWE and 6,900,657 participants as controls. Search terms included epilepsy and suicide. The pooled rates of suicidal ideation, suicide attempts and completed suicide in PWE were 19.73% (95% CI: 17.00-22.62%), 5.96% (95% CI: 4.82-7.20%), and 0.24% (95% CI: 0.11-0.42%), respectively. Compared to the control group, PWE were at a significantly higher risk of total suicidality (pooled OR, 2.60; 95%: 2.13-3.18), including suicidal ideation (pooled OR, 2.70; 95% CI, 2.21-3.30), suicide attempts (pooled OR, 2.74; 95% CI, 2.08-3.61) and completed suicide (pooled OR, 2.36; 95% CI, 1.45-3.83). Subgroup analyses showed significant differences in the subgroups of the measurement of suicidality.
The rate of suicidal ideation, suicide attempts and completed suicide in PWE were about 19.73, 5.96, and 0.24%. And there was an increased risk of suicidality in PWE especially temporal lobe epilepsy and drug-resistant epilepsy. Clinicians need to be aware of this risk in PWE with early identification and prevention at the time of diagnosis.Protocol Registration: PROSPERO CRD42021278220.
我们旨在评估癫痫与自杀行为之间的关联，包括自杀意念、自杀未遂和自杀死亡。
我们系统检索了1946年至2021年6月21日期间的PubMed、Embase、Cochrane在线图书馆和Clinicaltrials.gov，并使用纽卡斯尔-渥太华量表评估研究质量。我们计算了癫痫患者（PWE）自杀意念、自杀未遂和自杀死亡的合并比值比（OR）和粗发生率。
我们筛选了2786项研究，纳入了88篇文章，其中包括1178401例PWE和6900657名作为对照的参与者。检索词包括癫痫和自杀。PWE中自杀意念、自杀未遂和自杀死亡的合并发生率分别为19.73%（95%CI：17.00-22.62%）、5.96%（95%CI：4.82-7.20%）和0.24%（95%CI：0.11-0.42%）。与对照组相比，PWE发生总体自杀行为的风险显著更高（合并OR，2.60；95%：2.13-3.18），包括自杀意念（合并OR，2.70；95%CI，2.21-3.30）、自杀未遂（合并OR，2.74；95%CI，2.08-3.61）和自杀死亡（合并OR，2.36；95%CI，1.45-3.83）。亚组分析显示在自杀行为测量的亚组中存在显著差异。
PWE中自杀意念、自杀未遂和自杀死亡的发生率分别约为19.73%、5.96%和0.24%。PWE尤其是颞叶癫痫和耐药性癫痫患者的自杀风险增加。临床医生在诊断时需要意识到PWE的这种风险，并进行早期识别和预防。方案注册：PROSPERO CRD42021278220。
