Depression, hopelessness and suicide risk among patients suffering from epilepsy

Maurizio Pompili, Nicola Vanacore, Sara Macone, Mario Amore, Gianfranco Petriconi, Matteo Tonna, Enrico Sasso, David Lester, Marco Innamorati, Silvia Gazzella, Carlo Di Bonaventura, Annateresa Giallonardo, Paolo Girardi, Roberto Tatarelli, Eleonora De Pisa
Annali Dell'Istituto Superiore di Sanità 2007, 43 (4): 425-9
Suicide risk, as well as psychiatric disorder, has been repeatedly reported in the international literature as an important issue in the care of individuals suffering from epilepsy. In this pilot study a sample comprising 103 patients with a diagnosis of temporal lobe epilepsy, were collected from three clinics. The patients were administered the Beck hopelessness scale (BHS), the Beck depression inventory (BDI) and the Zung self-rating anxiety scale (SAS). Hopelessness has been identified as a construct linked to the prediction and the prevention of suicide. Twenty-six percent of the epileptic patients had scores>or=9 on the BHS, suggesting that they should be evaluated for suicidal inclinations. These patients were significantly older by about 9 years and had higher levels of depression and anxiety, but they did not differ in sex, age of onset of epilepsy or in their responsiveness to medication. In the logistic regression analysis, a hopelessness score>or=9 was predicted by BDI depression scores and SAS anxiety scores taking into account sex, age and response to epileptic medications. Despite a number of limitations, this pilot study adds support for the need for screening for suicide risk in patients with epilepsy. Both clinical and psychometric data should be part of the evaluation of the epileptic patient for psychiatric and suicidality assessment.

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