Prevalence of suicidality in children and adolescents with depressive disorders with and without epilepsy

Epilepsy Behav. 2023 Nov:148:109467. doi: 10.1016/j.yebeh.2023.109467. Epub 2023 Oct 14.

Abstract

Objective: Children with epilepsy (CWE) are at risk for a range of adverse emotional, behavioral, and social outcomes. Approximately one-third of CWE experience depressive disorders, and up to 20% of children and adolescents with epilepsy may experience suicidality, suggesting that epilepsy increases the risk for suicidality among children and adolescents with depressive disorders. Consequently, the goal of the present study is to compare rates of suicidality in children and adolescents diagnosed with depressive disorders with or without co-morbid epilepsy.

Participants and methods: A retrospective chart review was conducted for 100 pediatric patients with a history of both seizures and depressive disorders and 100 patients with a history of depressive disorders only. Cases were coded for depression diagnosis, suicidality, suicidal ideation, suicide attempts, psychiatric hospitalizations, and self-injury. The distributions of these variables for the two groups were compared.

Results: The age and sex distributions of the two groups were comparable. Patients with co-morbid depressive disorders and epilepsy found a high rate of suicidal ideation (69%) but did not differ from those with depressive disorders without epilepsy on any of the suicidality variables (all p > 0.20), with the exception of self-injury, which was higher in those without epilepsy.

Conclusions: CWE and co-morbid depression are at significant risk for suicidality, including ideation, attempts, and hospitalizations, but at rates that are comparable to those with depressive disorders without seizures. However, patients with co-morbid epilepsy are less likely to engage in other self-injurious behaviors. These findings support the need for careful monitoring of the psychiatric status of children and adolescents with epilepsy.

Keywords: Depression; Epilepsy; Pediatric; Psychiatric comorbities; Suicidality.

MeSH terms

  • Adolescent
  • Child
  • Depressive Disorder* / complications
  • Depressive Disorder* / epidemiology
  • Depressive Disorder* / psychology
  • Epilepsy* / complications
  • Epilepsy* / epidemiology
  • Epilepsy* / psychology
  • Humans
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Seizures
  • Suicidal Ideation
  • Suicide*