{"title":"癫痫患者自杀风险升高：一项系统回顾和荟萃分析。","authors":"Ali Rafati, Yeganeh Pasebani, Churl-Su Kwon","doi":"10.1007/s00415-025-12961-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Suicide is among the top 10 leading causes of death. Epilepsy is associated with increased diagnoses of psychiatric conditions. Approximately 5% of deaths in people with epilepsy (PwE) are caused by suicide. We aim to compare the suicide incidence in PwE vs. people without epilepsy.</p><p><strong>Methods: </strong>A systematic review was performed looking at suicide incidence among PwE compared to persons without epilepsy. The reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed in this study. The search included records until February 2024 in Ovid® MEDLINE, Embase®, and PsycINFO. Abstracts were screened in duplicate and extracted using standard proforma. Data were recorded on the incidence of suicide ideation, attempt, or completed suicide in PwE compared to persons without epilepsy. Meta-analyses were performed along with descriptive analyses.</p><p><strong>Results: </strong>Out of a total of 7,371 records identified from the systematic search, 13 met the eligibility criteria. Meta-analysis showed a significantly higher incidence proportion of suicide ideation in PwE than those without epilepsy (risk ratio [RR]: 2.06, 95% CI 1.47-2.89). For suicide attempts, incidence proportion (RR: 3.62, 95% CI 2.88-4.55), incidence rate (incidence rate ratio [IRR]: 4.94, 95% CI 4.44-5.50) and hazard (adjusted hazard ratio [HR]: 2.32, 95% CI 2.17-2.48) were all significantly higher in PwE vs. people without epilepsy. Lastly, incidence proportion (RR: 2.39, 95% CI 1.28-4.47), incidence rate (IRR: 2.26, 95% CI 2.13-2.40), and hazard (adjusted HR: 2.50, 95% CI 1.99-3.16) of completed suicide were all significantly higher in PwE than those without epilepsy.</p><p><strong>Significance: </strong>The incidence of suicide ideation, suicide attempt, and completed suicide were significantly higher in PwE compared to people without epilepsy. Comprehensive support systems to educate, diagnose, and manage epilepsy and concurrent psychiatric conditions in PwE are highly suggested.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 3","pages":"232"},"PeriodicalIF":5.4000,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Elevated suicide risk in individuals with epilepsy: a systematic review and meta-analysis.\",\"authors\":\"Ali Rafati, Yeganeh Pasebani, Churl-Su Kwon\",\"doi\":\"10.1007/s00415-025-12961-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Suicide is among the top 10 leading causes of death. Epilepsy is associated with increased diagnoses of psychiatric conditions. Approximately 5% of deaths in people with epilepsy (PwE) are caused by suicide. We aim to compare the suicide incidence in PwE vs. people without epilepsy.</p><p><strong>Methods: </strong>A systematic review was performed looking at suicide incidence among PwE compared to persons without epilepsy. The reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed in this study. The search included records until February 2024 in Ovid® MEDLINE, Embase®, and PsycINFO. Abstracts were screened in duplicate and extracted using standard proforma. Data were recorded on the incidence of suicide ideation, attempt, or completed suicide in PwE compared to persons without epilepsy. Meta-analyses were performed along with descriptive analyses.</p><p><strong>Results: </strong>Out of a total of 7,371 records identified from the systematic search, 13 met the eligibility criteria. Meta-analysis showed a significantly higher incidence proportion of suicide ideation in PwE than those without epilepsy (risk ratio [RR]: 2.06, 95% CI 1.47-2.89). For suicide attempts, incidence proportion (RR: 3.62, 95% CI 2.88-4.55), incidence rate (incidence rate ratio [IRR]: 4.94, 95% CI 4.44-5.50) and hazard (adjusted hazard ratio [HR]: 2.32, 95% CI 2.17-2.48) were all significantly higher in PwE vs. people without epilepsy. Lastly, incidence proportion (RR: 2.39, 95% CI 1.28-4.47), incidence rate (IRR: 2.26, 95% CI 2.13-2.40), and hazard (adjusted HR: 2.50, 95% CI 1.99-3.16) of completed suicide were all significantly higher in PwE than those without epilepsy.</p><p><strong>Significance: </strong>The incidence of suicide ideation, suicide attempt, and completed suicide were significantly higher in PwE compared to people without epilepsy. Comprehensive support systems to educate, diagnose, and manage epilepsy and concurrent psychiatric conditions in PwE are highly suggested.</p>\",\"PeriodicalId\":16558,\"journal\":{\"name\":\"Journal of Neurology\",\"volume\":\"272 3\",\"pages\":\"232\"},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2025-02-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00415-025-12961-0\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00415-025-12961-0","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：自杀是十大主要死亡原因之一。癫痫与精神疾病的诊断增加有关。约5%的癫痫患者死亡是由自杀造成的。我们的目的是比较PwE患者与非癫痫患者的自杀发生率。方法：对PwE患者与非癫痫患者的自杀发生率进行系统评价。本研究遵循系统评价首选报告项目和荟萃分析标准的报告指南。检索包括Ovid®MEDLINE、Embase®和PsycINFO中截至2024年2月的记录。摘要一式两份筛选，采用标准形式提取。与没有癫痫的人相比，记录了PwE患者自杀意念、企图或已完成自杀的发生率。meta分析与描述性分析同时进行。结果：从系统检索中确定的7371条记录中，有13条符合资格标准。meta分析显示，PwE患者自杀意念发生率明显高于未患癫痫的患者（风险比[RR]: 2.06, 95% CI 1.47 ~ 2.89）。在自杀企图方面，PwE患者的发生率（RR: 3.62, 95% CI 2.88-4.55）、发病率（发病率比[IRR]: 4.94, 95% CI 4.44-5.50）和危险性（校正危险比[HR]: 2.32, 95% CI 2.17-2.48）均显著高于非癫痫患者。最后，PwE患者自杀发生率（RR: 2.39, 95% CI 1.28 ~ 4.47）、发生率（IRR: 2.26, 95% CI 2.13 ~ 2.40）和危险性（校正HR: 2.50, 95% CI 1.99 ~ 3.16）均显著高于非癫痫患者。意义：PwE患者自杀意念、自杀企图和自杀未遂的发生率明显高于非癫痫患者。强烈建议综合支持系统来教育、诊断和管理PwE患者的癫痫和并发精神疾病。
Elevated suicide risk in individuals with epilepsy: a systematic review and meta-analysis.
Objective: Suicide is among the top 10 leading causes of death. Epilepsy is associated with increased diagnoses of psychiatric conditions. Approximately 5% of deaths in people with epilepsy (PwE) are caused by suicide. We aim to compare the suicide incidence in PwE vs. people without epilepsy.
Methods: A systematic review was performed looking at suicide incidence among PwE compared to persons without epilepsy. The reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed in this study. The search included records until February 2024 in Ovid® MEDLINE, Embase®, and PsycINFO. Abstracts were screened in duplicate and extracted using standard proforma. Data were recorded on the incidence of suicide ideation, attempt, or completed suicide in PwE compared to persons without epilepsy. Meta-analyses were performed along with descriptive analyses.
Results: Out of a total of 7,371 records identified from the systematic search, 13 met the eligibility criteria. Meta-analysis showed a significantly higher incidence proportion of suicide ideation in PwE than those without epilepsy (risk ratio [RR]: 2.06, 95% CI 1.47-2.89). For suicide attempts, incidence proportion (RR: 3.62, 95% CI 2.88-4.55), incidence rate (incidence rate ratio [IRR]: 4.94, 95% CI 4.44-5.50) and hazard (adjusted hazard ratio [HR]: 2.32, 95% CI 2.17-2.48) were all significantly higher in PwE vs. people without epilepsy. Lastly, incidence proportion (RR: 2.39, 95% CI 1.28-4.47), incidence rate (IRR: 2.26, 95% CI 2.13-2.40), and hazard (adjusted HR: 2.50, 95% CI 1.99-3.16) of completed suicide were all significantly higher in PwE than those without epilepsy.
Significance: The incidence of suicide ideation, suicide attempt, and completed suicide were significantly higher in PwE compared to people without epilepsy. Comprehensive support systems to educate, diagnose, and manage epilepsy and concurrent psychiatric conditions in PwE are highly suggested.
期刊介绍：
The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field.
In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials.
Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.
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