@article{4251d6b938bf44bdb2aaa2f559d59338,
title = "Sociodemographic and clinical risk factors for suicidal ideation and suicide attempt in functional/dissociative seizures and epilepsy: a large cohort study",
abstract = "BACKGROUND: People with functional/dissociative seizures (FDS) are at elevated suicidality risk.OBJECTIVE: To identify risk factors for suicidality in FDS or epilepsy.METHODS: Retrospective cohort study from the UK's largest tertiary mental healthcare provider, with linked national admission data from the Hospital Episode Statistics. Participants were 2383 people with a primary or secondary diagnosis of FDS or epilepsy attending between 01 January 2007 and 18 June 2021. Outcomes were a first report of suicidal ideation and a first hospital admission for suicide attempt (International Classification of Diseases, version 10: X60-X84). Demographic and clinical risk factors were assessed using multivariable bias-reduced binomial-response generalised linear models.FINDINGS: In both groups, ethnic minorities had significantly reduced odds of hospitalisation following suicide attempt (OR: 0.45-0.49). Disorder-specific risk factors were gender, age and comorbidity profile. In FDS, both genders had similar suicidality risk; younger age was a risk factor for both outcomes (OR: 0.16-1.91). A diagnosis of depression or personality disorders was associated with higher odds of suicidal ideation (OR: 1.91-3.01). In epilepsy, females had higher odds of suicide attempt-related hospitalisation (OR: 1.64). Age had a quadratic association with both outcomes (OR: 0.88-1.06). A substance abuse disorder was associated with higher suicidal ideation (OR: 2.67). Developmental disorders lowered the risk (OR: 0.16-0.24).CONCLUSIONS: This is the first study systematically reporting risk factors for suicidality in people with FDS. Results for the large epilepsy cohort complement previous studies and will be useful in future meta-analyses.CLINICAL IMPLICATIONS: Risk factors identified will help identify higher-risk groups in clinical settings.",
keywords = "Humans, Male, Female, Suicide, Attempted, Suicidal Ideation, Cohort Studies, Psychogenic Nonepileptic Seizures, Retrospective Studies, Risk Factors, Epilepsy/epidemiology",
author = "Irene Faiman and John Hodsoll and Iman Jasani and Young, {Allan H} and Paul Shotbolt",
note = "Funding Information: IF, JH, IJ and PS\u2014none to declare. AY\u2014employed by King\u2019s College London; honorary consultant of SLaM (NHS UK); deputy editor of BJPsych Open; paid lectures and advisory boards for the following companies with drugs used in affective and related disorders: AstraZeneca, Eli Lilly, Lundbeck, Sunovion, Servier, LivaNova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma, COMPASS, Sage and Novartis; consultant to Johnson & Johnson and LivaNova; received honoraria for attending advisory boards and presenting talks at meetings organised by LivaNova; principal investigator in the Restore-Life VNS registry study funded by LivaNova; principal investigator on ESKETINTRD3004: \u2018An Open-label, Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression\u2019; principal investigator on \u2018The Effects of Psilocybin on Cognitive Function in Healthy Participants\u2019; principal investigator on \u2018The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD)\u2019; UK chief investigator for Novartis MDD Study MIJ821A12201; grant funding (past and present): NIMH (USA), CIHR (Canada), NARSAD (USA), Stanley Medical Research Institute (USA), MRC (UK), Wellcome Trust (UK), Royal College of Physicians (Edin), BMA (UK), UBC-VGH Foundation (Canada), WEDC (Canada), CCS Depression Research Fund (Canada), MSFHR (Canada), NIHR (UK) and Janssen (UK); no shareholdings in pharmaceutical companies. Funding Information: We would like to acknowledge Dr Elena Bernardini for a discussion on the correlates and theories of suicidality. We would like to acknowledge the Bergqvist Charitable Trust and the Psychiatry Research Trust for their financial support. We would like to acknowledge the Office for National Statistics (ONS) as the provider of the mortality data; those who carried out the original collection and analysis of the data bear no responsibility for their further analysis or interpretation. For the purposes of open access, the authors have applied a Creative Commons Attribution (CC BY) licence to any Accepted Author Manuscript version arising from this submission. This work was supported by the Bergqvist Charitable Trust through the Psychiatry Research Trust as a PhD scholarship to IF. This study represents independent research partly funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King\u2019s College London. AY\u2019s independent research is funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King\u2019s College London. Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2024.",
year = "2024",
month = apr,
day = "19",
doi = "10.1136/bmjment-2023-300957",
language = "English",
volume = "27",
journal = "BMJ mental health",
issn = "2755-9734",
publisher = "BMJ Publishing Group",
number = "1",
}
