Evaluating clinical risk factors for suicide attempts in patients with epilepsy

Objective: We would like to exam whether epilepsy patients in Taiwan have a high risk of attempted and completed suicide. Methods: In this study, we used a subset of the National Health Insurance Research Database (NHIRD) of Taiwan. Inpatients (>= 18 years) who received a new diagnosis of epilepsy between 2000 and 2011 were enrolled in the epilepsy cohort. The epilepsy and comparison cohorts included 68,543 patients and 2-fold controls respectively. We calculated the adjusted hazard ratio (aHR) for suicide attempts after adjustment for age, sex, monthly income, the urbanization level, occupation, and comorbidity. Results: The epilepsy cohort had a 2.06-fold risk of suicide attempts (95% CI = 1.65-2.56) compared with the control cohort. The suicide attempt risk did not significantly differ between men and women and between patients with and without psychiatric comorbidity. The mortality risk after a suicide attempt was higher in the epilepsy cohort than in the comparison cohort (aHR = 1.66, 95% CI = 1.02-2.69). Conclusion: Epilepsy is an independent and predisposing factor for suicide attempt. These results provide important information for clinicians and governments to prevent suicide in epilepsy patients in Asian countries.