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Youths with childhood epilepsy at risk of self-harm

19 Nov 2020

Childhood epilepsy carries an increased risk of self-harm in children, teens, and young adults, as suggested in a study.

The analysis included 339 children, aged 1 month through 17 years, with new-onset epilepsy and 678 healthy children who were followed until a median age of 24.7 and 23.4 years, respectively. Of these, 98 participants had self‐injurious behaviour or suicidal ideation (43 with epilepsy and 55 controls) according to the Columbia Suicide Severity Rating Scale.

Specifically, 32 individuals with epilepsy and 42 controls reported at least one instance of suicidal ideation or attempt. All completed suicides among epilepsy cases involved boys, including one gunshot to the head at age 16 years, one carbon monoxide poisoning at age 20 years, and one alcohol poisoning at age 18 years. Among controls, one suicide death was documented in a 24-year-old woman due to a gunshot to the chest.

On multivariable Cox analysis, epilepsy was associated with greater incidence of any self‐injurious behaviour and suicidal ideation (hazard ratio [HR], 1.56, 95 percent confidence interval [CI], 1.04–2.35) and a trend toward a heightened risk of suicidal ideation and attempt (HR, 1.48, 95 percent CI, 0.93–2.37).

Patients and controls with self‐injurious behaviour or suicidal ideation both had an increased prevalence of earlier mood and substance abuse disorders. However, a previous attention‐deficit/hyperactivity disorder was more than twice as common in the epilepsy group.

No specific epilepsy‐related variable correlated with the risk of self‐injurious behavior or suicidal ideation.

The findings underscore the importance of integrating careful screening of mental health concerns into routine epilepsy care.

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