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Epilepsy, suicidality, and psychiatric disorders: A bidirectional association
Abstract
Objective: A study was undertaken to determine whether psychiatric disorders associated with suicide are more common in incident epilepsy than in matched controls without epilepsy, before and after epilepsy diagnosis. Methods: A matched, longitudinal cohort study was conducted in the UK General Practice Research Database. A total of 3,773 cases diagnosed with epilepsy between the ages of 10 and 60 years were compared to 14,025 controls matched by year of birth, sex, general practice, and years of medical records before the index date. We examined first diagnosis of psychosis, depression, anxiety, and suicidality in each of the 3 years before and after the index date and annual prevalence of suicide. Referent diagnoses were eczema and acute surgery. The incidence rate ratio (IRR) was calculated for each year in the study period; the prevalence ratio (PR) was calculated for suicidality. Results: The IRR of psychosis, depression, and anxiety was significantly increased for all years before epilepsy diagnosis (IRR, 1.5–15.7) and after diagnosis (IRR, 2.2–10.9) and for suicidality before epilepsy diagnosis (IRR, 3.1–4.5) and 1 year after diagnosis (IRR, 5.3). The PR was increased for suicide attempt before epilepsy onset (PR, 2.6–5.2) and after onset (PR, 2.4–5.6). Eczema and acute surgery were both associated with epilepsy in the first and third year after diagnosis. Interpretation: Epilepsy is associated with an increased onset of psychiatric disorders and suicide before and after epilepsy diagnosis. These relations suggest common underlying pathophysiological mechanisms that both lower seizure threshold and increase risk for psychiatric disorders and suicide. ANN NEUROL 2012
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“Also, large epidemiological studies have shown increased risks of psychiatric disorders in other chronic pediatric diseases (5,6)”
From Risks of psychiatric disorders and suicide attempts in children and adolescents with type 1 diabetes: a population-based cohort study (2015) · cites this paper as [6]
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Lee, G.-H., Lee, S., No, S.-K., Lee, S., Ryu, J.-Y., Jo, K.-D., Kwon, J., Kim, O.-J., Park, H.-K., Kwon, O.-Y., et al. (2015) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2015.10.024 · Cited by 47
Psychoses in epilepsy: A comparison of postictal and interictal psychoses
Hilger, E., Zimprich, F., Pataraia, E., Aull‐Watschinger, S., Jung, R., Baumgartner, C., & Bonelli, S. B. (2016) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2016.04.005 · Cited by 47
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Alessi, N., Perucca, P., & McIntosh, A. M. (2021) · Epilepsia · doi:10.1111/epi.16929 · Cited by 45
Shou, J., & Shaw, P. (2022) · Cells · doi:10.3390/cells11050796 · Cited by 48
Ritter, A. C., Wagner, A. K., Szaflarski, J. P., Brooks, M. M., ZAFONTE, R. D., Pugh, M. J., Fabio, A., Hammond, F. M., Dreer, L. E., Bushnik, T. L., et al. (2016) · Epilepsia · doi:10.1111/epi.13470 · Cited by 46
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Self-citationEpilepsy With Suicide: A Bibliometrics Study and Visualization Analysis via CiteSpace
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The intersections of stress, anxiety and epilepsy
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Metadata
- Authors
- Hesdorffer, D. C., Ishihara, L., Mynepalli, L., Webb, D. J., Weil, J., & Hauser, W. A.
- Affiliations
- Columbia University (US)
- GlaxoSmithKline (United Kingdom) (GB)
- GlaxoSmithKline (India) (IN)
- Corresponding author
- Hesdorffer, Dale C.
- Venue
- Annals of Neurology
- Publisher
- Wiley
- Published
- 2012-08
- Volume
- 72
- Issue
- 2
- Pages
- 184-191
- ISSN
- 0364-5134 (ISSN-L)
- 1531-8249
- OpenAlex
- W1973942337
- Cited by
- 610
- References
- 46
- Citations by year
- 2026: 21 · 2025: 58 · 2024: 58 · 2023: 41 · 2022: 44 · 2021: 45 · 2020: 63 · 2019: 38 · 2018: 33 · 2017: 41 · 2016: 49 · 2015: 40 · 2014: 42 · 2013: 30 · 2012: 6
- FWCI
- 26.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- GlaxoSmithKline
- Topics
- Health Sciences › Medicine › Clinical Neurology › Epilepsy research and treatment
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- epilepsy, suicidality, suicide attempts, psychiatric comorbidity, psychosis, depression, anxiety, bidirectional relationship, seizure threshold
- MeSH terms
- Adolescent, Adult, Mental Disorders, Child, Epilepsy, Female, United Kingdom, Humans, Male, Middle Aged, Suicide, Cohort Studies, Comorbidity, Incidence, Confidence Intervals, Case-Control Studies, Young Adult
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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