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Review
. 2023 Mar 29:14:1097516.
doi: 10.3389/fpsyt.2023.1097516. eCollection 2023.

Suicidality and epilepsy: A systematic review and meta-analysis

Haijiao Wang  1   2 , Yu Zhang  1   3 , Ge Tan  1 , Deng Chen  1 , Yaoqi Fu  1 , Ling Liu  1
Affiliations
Review

Suicidality and epilepsy: A systematic review and meta-analysis

Haijiao Wang et al. Front Psychiatry. .

Abstract

Background: We aimed to evaluate the association between epilepsy and suicidality, including suicidal ideation, attempts and completed suicide.

Methods: 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).

Results: 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.

Conclusion: 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.

Keywords: completed suicide; epilepsy; incidence rate; suicidal ideation; suicide attempt.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A flow diagram of the article screening process.
Figure 2
Figure 2
The risk of suicidality between patients with epilepsy and controls.
Figure 3
Figure 3
The crude rate of suicidal ideation in patients with epilepsy.
Figure 4
Figure 4
The crude rate of suicide attempts in patients with epilepsy.
Figure 5
Figure 5
The crude rate of completed suicide in patients with epilepsy.
See this image and copyright information in PMC

References

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