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Meta-Analysis
. 2019 Apr 24;16(8):1451.
doi: 10.3390/ijerph16081451.

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

Nicholas Abraham  1 , P Buvanaswari  2 , Rahul Rathakrishnan  3 , Bach X Tran  4   5   6 , Giang Vu Thu  7 , Long H Nguyen  8 , Cyrus S Ho  9 , Roger C Ho  10   11
Affiliations
Meta-Analysis

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

Nicholas Abraham et al. Int J Environ Res Public Health. .

Abstract

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.

Keywords: epilepsy; meta-analysis; prevalence; suicide.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Process of systematic selection of articles. PWE, people with epilepsy.
Figure 2
Figure 2
Forest plot of pooled odds ratio of suicide attempts among PWE and controls from case-control studies. CI, confidence interval.
Figure 3
Figure 3
Forest plot of pooled prevalence rate of suicide attempts among PWE.
Figure 4
Figure 4
Forest plot of pooled rate of death by suicide among PWE.
Figure 5
Figure 5
Forest plot of pooled rate of rate of suicide ideation among PWE.
See this image and copyright information in PMC

References

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