Suicidal risk, affective dysphoric disorders, and quality-of-life perception in patients with focal refractory epilepsy

- Evaluation the association among QOL, affective disorders and suicidal risk.
- ASDD and severity of the depressive disorder are related to suicidal risk.
- Lower QOL is a predictor of an increase in suicidal risk.

ObjectivesWe aim to study the frequency of (suicidal ideation) in patients with focal refractory epilepsy and its possible association with factors such as perceived QOL (quality of life) and ASDD (affective somatoform dysphoric disorder) using the 2007 ILAE proposal to classify affective disorders of epilepsy.MethodsA total sample of 82 patients was divided into two groups depending on the presence of suicidal risk: (A) study group - with suicidal risk and (B) control group - without suicidal risk. Questionnaires, scales, interviews, and clinical charts were evaluated by professionals with expertise in neurology and epileptology (RAM and AGA), psychiatry (AGE), and neuropsychology (FGR). Suicidal risk was evaluated with the M.I.N.I. (Mini-International Neuropsychiatric Interview) suicidal module that specifies the current suicidal risk based on scores. Quality of life was evaluated with the Quality of Life in Epilepsy Inventory - 31 (QOLIE-31) survey. Logistic regression was conducted to ascertain if ASDD and QOL significantly predicted suicidal risk. The results were considered statistically significant when the p-value was < 0.05.ResultsSuicidal risk was present in 33 (40.3%) patients. It was classified as severe in 31.7% of the patients, and it was only present in cases with temporal lobe epilepsy (p = 0.002). More than half (52%) of patients with ASDD had risk of suicide (p = 0.006). The presence of ASDD was found to be a risk factor for suicidal risk (OR = 3.86; IC = 1.3-12.2). Patients with suicidal risk had a lower QOL score compared with patients without suicidal risk (57.8 ± 16.9 vs. 46.0 ± 18.2; p < 0.05), and an affected QOL significantly increased suicidal risk (OR = 2.9; CI = 1.3-7.8). Multivariate analysis demonstrated that an impaired QOL (OR = 2.2) and the presence of ASDD (OR = 4.1) significantly increased the probability of having suicidal risk (x2 = 13.6; OR = 5.2; p = 0.009).SignificanceAffective somatoform dysphoric disorder and low QOL perception increase, independently, the risk of suicide.