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Prevalence of suicide attempts and their risk factors in school-aged patients with epilepsy: a population-based study

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Abstract

Suicide prevention is a critical issue for young people. However, no large body of representative data on the risk of suicide attempts in school-aged patients with epilepsy in Taiwan or other developing countries is available. Patients aged ≤ 18 years who received a diagnosis of epilepsy between 2000 and 2012 were included in the epilepsy cohort (N = 9801). The comparison cohort was matched to the epilepsy cohort at a ratio of 4:1. We calculated the adjusted hazard ratio and 95% confidence intervals (CIs) for suicide attempts after adjustment for age, sex, urbanization level, parental occupation category, comorbidities, and follow-up time. Further analysis was performed to assess the dose–response effect on the risk of attempting suicide based on the average frequency of medical visits for epilepsy. The overall incidence rates of suicide attempts in the epilepsy and comparison cohorts were 15.7 and 5.89 per 100,000 people per year, respectively. The epilepsy cohort had a 2.34-fold higher risk of suicide being attempted (95% CI 2.17–2.52) than did the comparison cohort. Male sex, over 12 years of age, and parental occupation of office work were found to be the major risk factors for suicide attempts. Epilepsy might be an independent factor predisposing school-aged patients to suicide attempts. The results of this study could provide clinicians and governments with vital information on suicide prevention for young people with epilepsy in Taiwan and other developing countries.

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Acknowledgements

This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW106-TDU-B-212-113004), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10601010036), Taiwan Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo AoshimaMemorial Funds, Japan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.

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Authors and Affiliations

  1. Department of Neurosurgery, Hualien Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan

    Tomor Harnod

  2. College of Medicine, Tzu Chi University, Hualien, Taiwan

    Tomor Harnod

  3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    Cheng-Li Lin

  4. College of Medicine, China Medical University, Taichung, Taiwan

    Cheng-Li Lin

  5. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan

    Chia-Hung Kao

  6. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan

    Chia-Hung Kao

  7. Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan

    Chia-Hung Kao

Authors
  1. Tomor Harnod
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  2. Cheng-Li Lin
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  3. Chia-Hung Kao
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Contributions

Conception/design of study: TH, C-HK. Provision of study material and patients: C-HK. Collection and assembly of data: all authors. Analysis and interpretation of data: all authors. Manuscript writing: all authors. Approval of final manuscript: all authors.

Corresponding author

Correspondence to Chia-Hung Kao.

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We confirm that we have read the journal guidelines on ethical publication and that this study complies with these guidelines.

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Harnod, T., Lin, CL. & Kao, CH. Prevalence of suicide attempts and their risk factors in school-aged patients with epilepsy: a population-based study. Eur Child Adolesc Psychiatry 27, 1047–1053 (2018). https://doi.org/10.1007/s00787-018-1118-z

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  • DOI: https://doi.org/10.1007/s00787-018-1118-z

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