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Open AccessArticle

A Meta-Analysis of the Rates of Suicide Ideation, Attempts and Deaths in People with Epilepsy

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Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
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Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore
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Division of Neurology, University Medical Cluster, National University Health System, Singapore 119228, Singapore
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Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam
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Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
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Vietnam Young Physicians’ Association, Hanoi 100000, Vietnam
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Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam
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Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam
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Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore 119228, Singapore
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(8), 1451; https://doi.org/10.3390/ijerph16081451
Received: 20 January 2019 / Revised: 15 April 2019 / Accepted: 19 April 2019 / Published: 24 April 2019
(This article belongs to the Special Issue Adult Psychiatry )
This meta-analysis aimed to evaluate the association between epilepsy and suicide. We systematically searched PubMed, PsycINFO, Embase and Web of Science for studies that reported the prevalence of suicidality in the form of suicide ideation, attempts and deaths among people with epilepsy (PWE). Studies were included if they reported the numbers of patients who died by suicide and concurrently suffered from epilepsy, assessed suicide ideation, or studied suicide attempts in PWE by validated instruments or diagnostic interviews. We used the random effects model to calculate the pooled odds ratios (OR) and standard mean differences (SMDs). We performed subgroup analyses. Seven case-control studies were included in the comparison of rates of suicide attempts between PWE and controls, with a total of 821,594 participants. Our analyses demonstrated a positive association between epilepsy and suicide attempts (pooled OR = 3.25, 95% confidence interval (CI): 2.69–3.92, p < 0.001), indicating that PWE have an elevated risk of suicide. The pooled prevalence for suicide ideation (24 studies) and suicide attempts (18 studies) were 23.2% (95% CI: 0.176–0.301) and 7.4% (95% CI: 0.031–0.169) respectively. The pooled rate of death due to suicide (10 studies) was 0.5% (95% CI: 0.002–0.016). Meta-regression showed that mean age and proportion of male gender were significant moderators for prevalence of suicide attempts and death due to suicide in PWE. Young PWE could be triggered by relationship problems and male PWE might use more lethal methods to attempt suicide. This meta-analysis provides the most up-to-date information on the prevalence of suicide among people with epilepsy and guidance on strategies to improve current psychiatric services provided for this population. View Full-Text
Keywords: epilepsy; meta-analysis; prevalence; suicide epilepsy; meta-analysis; prevalence; suicide
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Abraham, N.; Buvanaswari, P.; Rathakrishnan, R.; Tran, B.X.; Thu, G.V.; Nguyen, L.H.; Ho, C.S.; Ho, R.C. A Meta-Analysis of the Rates of Suicide Ideation, Attempts and Deaths in People with Epilepsy. Int. J. Environ. Res. Public Health 2019, 16, 1451.

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