Risk factors for self-harm in people with epilepsy

Gorton, Hayley C.; Webb, Roger T.; Pickrell, William Owen; Carr, Matthew; Ashcroft, Darren M.

doi:10.1007/s00415-018-9094-2

Cited by 12 publications

(11 citation statements)

References 26 publications

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“…Separately in each dataset, we identified people as having incident epilepsy if they had the first evidence of a code for epilepsy diagnosis and an associated prescription for an antiepileptic drug (AED) in the month before or 6 months after the diagnosis. The requirement for both an epilepsy diagnosis and AED treatment is suggested to increase the reliability of the ascertainment of epilepsy in observational studies, by the International League Against Epilepsy (ILAE) ( 12 ) and is a definition we have previously applied in epidemiological studies of epilepsy ( 13 ). The use of primary care records in the SAIL Databank to identify people with epilepsy has been validated ( 14 ).…”

Section: Methodsmentioning

confidence: 99%

Alcohol-Specific Mortality in People With Epilepsy: Cohort Studies in Two Independent Population-Based Datasets

et al. 2021

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Objectives: The risk of dying by alcohol-specific causes in people with epilepsy has seldom been reported from population-based studies. We aimed to estimate the relative risk of alcohol-specific mortality in people with epilepsy, and the extent to which problematic alcohol use was previously identified in the patients' medical records.Method: We delineated cohort studies in two population-based datasets, the Clinical Practice Research Datalink (CPRD GOLD) in England (January 01, 2001–December 31, 2014) and the Secure Anonymised Information Linkage (SAIL) Databank in Wales (January 01, 2001–December 31, 2014), linked to hospitalization and mortality records. People with epilepsy were matched to up to 20 persons without epilepsy on gender, age (±2 years) and registered general practice. We identified alcohol-specific death from Office for National Statistics (ONS) records using specified ICD-10 codes. We further identified prescriptions, interventions and hospitalisations related to alcohol use.Results: In the CPRD GOLD, we identified 9,871 individuals in the incident epilepsy cohort and 185,800 in the comparison cohort and, in the SAIL Databank, these numbers were 5,569 and 110,021, respectively. We identified a five-fold increased risk of alcohol-specific mortality in people with epilepsy vs. those without the condition in our pooled estimate across the two datasets (deprivation-adjusted HR 4.85, 95%CI 3.46–6.79).Conclusions: People with epilepsy are at increased risk of dying by an alcohol-specific cause than those without the disorder. It is plausible that serious alcohol misuse could either contribute to the development of epilepsy or it could commence subsequent to epilepsy being diagnosed. Regardless of the direction of the association, it is important that the risk of dying as a consequence of alcohol misuse is accurately quantified in people affected by epilepsy. Systematically-applied, sensitive assessment of alcohol consumption by healthcare professionals, at opportunistic, clinical contacts, with rapid access to quality treatment services, should be mandatory and play a key role in reduction of health harms and mortality.

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Section: Methodsmentioning

confidence: 99%

Alcohol-Specific Mortality in People With Epilepsy: Cohort Studies in Two Independent Population-Based Datasets

et al. 2021

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“…Different studies indicate that people who are taking 2 or more AED are at increased risk of suicidality and non-fatal self-harm behaviors. A study done in England showed an increased risk of suicidality for two AED with (OR 1.84, 95% CI 1.33-2.55) or three or more AEDs (OR 2.44, 95% CI 1.51-3.94) (10,23). similarly, trials on 11 types of AEDs from a pharmaceutical company on 28 000 patients showed a risk increase by almost 2 times (OR 1.8 95% CI, 1.24-2.66) (6, 32).…”

Section: Characteristicsmentioning

confidence: 99%

“…A cut-off value of PHQ-9 ≥ 5 was used to identify depression. severity scores consist of none (0-4), mild (5-9), moderate (10)(11)(12)(13)(14), moderately severe (15)(16)(17)(18)(19), and severe (20)(21)(22)(23)(24)(25)(26)(27). The third section was a tool to identify and assess Suicidality.…”

Section: Data Collection and Quality Assurancementioning

confidence: 99%

“…Psychiatric disorders and Suicidality are often comorbidities among patients with epilepsy (4,7,12,13). Apart from the perceived stigma of epilepsy and suicide, sociodemographic variation and psychiatric comorbidities pose an important factor to hinder help-seeking behaviors in people living with epilepsy, which in turn leads to an increased risk of suicidality and self-harm behaviors (10,14).…”

Section: Introductionmentioning

confidence: 99%

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Suicidality and Non-Fatal Self-Injury Behaviors Among Epileptic Patients in Neurology Clinic at Zewditu Memorial Hospital and Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, a Cross-Sectional Study

Anbessie

Gebrehanna

Zewde

et al. 2022

Preprint

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Background: - Suicidality /suicidal ideation and plan/ and non-fatal self-harm behaviors are more frequent among People living with Epilepsy (PWE) than the general population. The increased risk of suicidality and non-fatal self-harm behaviors and associated factors among people with Epilepsy varies across sociodemographic and disease-related factors as well as comorbid psychiatric conditions. The study aimed to determine the magnitude of suicidality and non-suicidal self-injury behaviors and identify its associated factors among People with Epilepsy seeking medical care at Amanuel Mental Specialized Hospital and Zewditu Memorial Hospital, Addis Ababa, Ethiopia 2021. Methods: - Facility-based cross-sectional study was conducted on randomly selected 345 epileptic patients that attended the outpatient neurology treatment service at Amanuel Mental Specialized Hospital and Zewditu Memorial Hospital. The study was conducted from 15 December 2020 to 15 February 2021. The WHO composite international diagnostic interview (CIDI) was used to assess suicidality, depression, and epilepsy-related factors. Association between outcome variables and selected independent variables was tested using a logistic regression model. Result: - The magnitude of suicidal ideation, plan, and non-fatal self-injury behavior among people living with epilepsy were 21.2, 18.3, and 11.9% respectively. Living alone, Poor social support, and comorbid depression were significantly associated with suicidal ideation, plan, and nonfatal self-injurious behavior. Those who were taking 2 or more Anti-Epileptic Drugs also showed statistical association with suicidal ideation (AOR 0.45, 95% CI= .21, .97; p=0.041) and suicidal plan (AOR 0.36, 95% CI= .162, .815; p=0.014) respectively. Conclusion - The prevalence of suicidal ideation, and non-fatal self-injurious behavior among people with epilepsy was high among Ethiopian epileptic patients in a hospital setting. Routine screening and proper intervention for comorbid depression as well as avoiding polytherapy might prevent suicidality and non-fatal self-injurious behavior, A strong social support also helped in preventing suicide as well as improving quality of life.

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“…Percebeu-se um risco cinco vezes maior associado ao histórico de uso indevido de álcool e outras substâncias. Isso poderia contribuir para o aumento do risco de automutilação experimentado por esses indivíduos (Gorton et al, 2018).…”

Section: Diagnóstico Prévio De Transtorno Mentalunclassified

Automutilação e seus fatores determinantes: Uma revisão integrativa

Lima

Oliveira

França

et al. 2021

RSD

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O objetivo deste estudo foi analisar, na literatura científica nacional e internacional, o que tem sido produzido sobre fatores determinantes da automutilação. Realizou-se uma revisão integrativa a partir da seguinte questão norteadora: Quais evidências científicas estão sendo publicadas sobre a automutilação e seus fatores de risco? A busca ocorreu em quatro bases de dados e abrangeu artigos com texto completo disponível, publicados entre 2016 e 2021, nos idiomas português, inglês e espanhol. A partir da amostra de 16 artigos, obteve-se com os resultados: fatores de adversidade familiar, acontecimentos adversos na infância, o contágio social da internet e o diagnóstico prévio de transtorno mental como importantes determinantes da automutilação nas diversas etapas da vida. Conclui-se que por se tratar de um problema de origem multifatorial, necessita de intervenções intersetoriais que proporcionem um cuidar holístico e de clínica ampliada. Portanto, sendo já considerado um problema de Saúde Pública nacional e internacional, é necessário a construção de Políticas Públicas que contenham o crescimento do número de casos e promovam a prevenção das diversas formas de violência autoprovocada.

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Risk factors for self-harm in people with epilepsy

Cited by 12 publications

References 26 publications

Alcohol-Specific Mortality in People With Epilepsy: Cohort Studies in Two Independent Population-Based Datasets

Alcohol-Specific Mortality in People With Epilepsy: Cohort Studies in Two Independent Population-Based Datasets

Suicidality and Non-Fatal Self-Injury Behaviors Among Epileptic Patients in Neurology Clinic at Zewditu Memorial Hospital and Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, a Cross-Sectional Study

Automutilação e seus fatores determinantes: Uma revisão integrativa

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