Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Causative Factors for Suicide Attempts by Overdose in Epileptics

Causative Factors for Suicide Attempts by Overdose in Epileptics Abstract • We investigated possible causative factors for the high epileptic suicide rate by reviewing the cases of 22 patients with idiopathic epilepsy found among 711 patients hospitalized for a suicide attempt by overdose. Suicide attempts occurred with increased seizure activity in one epileptic; otherwise, no relationships were found with seizure-related variables. When matched by age, sex, and race with 44 nonepileptic controls from the same population, the epileptics had more borderline personality disorders with multiple impulsive suicide attempts (45.5% vs 13.6%), more psychotic disturbances, including command hallucinations (31.8% vs 9.1%), fewer adjustment disorders (18.2% vs 45.5%), and a comparable frequency of depression (13.6% vs 25%). We conclude that suicide attempts in epileptics are primarily associated with interictal psychopathologic factors, such as borderline personality disorder and psychosis, rather than with specific psychosocial stressors, seizure variables, or anticonvulsant medications. References 1. Barraclough B. Suicide and epilepsy . In Reynolds E, Trimble MR, eds. Epilepsy and Psychiatry . New York, NY: Churchill Livingstone Inc; 1981:72-76. 2. Mathews WS, Barabas G. Suicide and epilepsy: a review of the literature . Psychosomatics . 1981;22:515-524.Crossref 3. Hawton K, Fagg J, Marsack P. Association between epilepsy and attempted suicide . J Neurol Neurosurg Psychiatry . 1980;43:168-180.Crossref 4. MacKay A. Self-poisoning: a complication of epilepsy . Br J Psychiatry . 1979;134:277-282.Crossref 5. Robertson MM, Trimble MR, Townsend HRA. Phenomenology of depression in epilepsy . Epilepsia . 1987;28:364-372.Crossref 6. Diehl LW. Epilepsie und Suizid . Psychiatr Neurol Med Psychol . 1986;38:625-633. 7. Sato T. The prognosis of epileptic seizures: review of the literatures . Fol Psychiatr Neurol Jpn . 1977;31:279-289. 8. Mendez MF. Psychopathology in epilepsy, prevalence, phenomenology and management . Int J Psychiatry . 1988;18:193-210.Crossref 9. Delay J, Deniker P, Barande R. Le suicide des epileptique . Encephale . 1957;46:401-436. 10. Gunn J. Affective and suicidal symptoms in epileptic prisoners . Psychol Med . 1973;3:108-114.Crossref 11. Mendez MF, Cummings JL, Benson DF. Depression in epilepsy, significance and phenomenology . Arch Neurol . 1986;43:766-770.Crossref 12. Jensen I. Temporal lobe epilepsy: late mortality in patients treated with unilateral temporal lobe resections . Acta Neurol Scand . 1975;52:374-380.Crossref 13. Brent DA. Overrepresentation of epileptics in a consecutive series of suicide attempters seen at a children's hospital, 1978-1983 . J Acad Child Psychiatry . 1986;25:242-246.Crossref 14. Monk M. Epidemiology of suicide . Epidemiol Rev . 1987;9:51-69. 15. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 16. Pike MC, Morrow RH. Statistical analysis of patient-control studies in epidemiology: factor under investigation on all-or-none variable . Br J Prev Soc Med . 1970;24:42-44. 17. Prudhomme C. Epilepsy and suicide . J Nerv Ment Dis . 1941;94:722-731.Crossref 18. Zielinski JJ. Epilepsy and mortality rate and cause of death . Epilepsia . 1974;15:191-201.Crossref 19. Iivanainen M, Lehtimen J. Causes of death in institutionalized epileptics . Epilepsia . 1979;30:485-492.Crossref 20. Henriksen PB, Juul-Jensen F, Lund M. Mortality of epileptics . In: Brackenridge RDC, ed. Life Assurance Medicine . London, England: Pitman Ltd., 1970:139-148. 21. Krohn W. Causes of death among epileptics . Epilepsia . 1963;4:315-321.Crossref 22. Whitlock FA. Suicide and physical illness . In Roy A, ed. Suicide . Baltimore, Md: Williams & Wilkins; 1986:151-170. 23. Suicide and epilepsy . Br Med J . 1980;281:530. Editorial.Crossref 24. Batzel LW, Dodrill CB. Emotional and intellectual correlates of unsuccessful suicide attempts in people with epilepsy . J Clin Psychol . 1986;42:699-702.Crossref 25. Williams D. The structure of emotions reflected in epileptic experiences . Brain . 1956;79:29-67.Crossref 26. Ferrari M, Barabas G, Mathews W. Psychologic and behavioral disturbance among epileptic children treated with barbiturate anticonvnlsants . Am J Psychiatry . 1983;140:112-113. 27. Tucker GJ, Price TRP, Johnson VB, McAllister T. Phenomenology of temporal lobe dysfunction: a link to atypical psychosis: a series of cases . J Nerv Ment Dis . 1986;174:348-356.Crossref 28. Gudmundsson G. Epilepsy in Iceland: a clinical and epidemiological investigation . Acta Neurol Scand . 1966;25( (suppl) ):1-124. 29. Rutter M, Graham P, Yule W. The prevalence of psychiatric disorder in neuro-epileptic children . In: Rutter M, Graham P, Yule W. A Neuropsychiatric Study in Childhood: Clinics in Developmental Medicine . London, England: Heineman Medical Book Ltd; 1979;35:175-185. 30. Pond DA, Bidwell BH. A survey of epilepsy in 14 general practices, II: social and psychological aspects . Epilepsia . 1959;60:285-299.Crossref 31. Lindsay J, Ounsted C, Richards P. Longterm outcome in children with temporal lobe seizures, III: psychiatric aspects in childhood and adult life . Dev Med Child Neurol . 1979;21:630-636.Crossref 32. Ervin F, Epstein RW, King HE. Behavior of epileptic and nonepileptic patients with 'temporal spikes.' Arch Neurol Psychiatry . 1955;74:488-497.Crossref 33. McKenna PJ, Kane JM, Parrish K. Psychiatric syndromes in epilepsy . Am J Psychiatry . 1985;142:895-903. 34. Dongier1 S. Statistical study of clinical and electroencephalographic manifestations of 536 psychotic episodes occurring in 516 epileptics between clinical seizures . Epilepsia . 1959/60;1:117-142.Crossref 35. Betts TA. Depression, anxiety and epilepsy . In: Reynolds EH, Trimble MR, eds. Epilepsy and Psychiatry . New York, NY: Churchill Livingstone Inc; 1981:60-71. 36. Hancock JC, Bevilacqua AR. Temporal lobe dysrhythmia and impulsive or suicidal behavior . South Med J . 1971;64:1189-1193.Crossref 37. Anastassopoulos G, Kokkini D. Suicidal attempts in psychomotor epilepsy . Behav Neuropsychiatry . 1969;1:11-16. 38. Engel J Jr, Kuhl DE, Phelps ME, Mazziotta JC. Interictal cerebral glucose metabolism in partial epilepsy and its relation to EEG changes . Ann Neurol . 1982;12:510-517.Crossref 39. Adamec RE, Stark-Adamec C. Limbic Kindling in animal behavior: implications for human psychopathology associated with complex partial seizures . Biol Psychiatry . 1983;18:269-293. 40. Weil AA. Depressive reactions associated with temporal lobe-uncinate seizures . J Nerv Ment Dis . 1955;121:505-510.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Causative Factors for Suicide Attempts by Overdose in Epileptics

Loading next page...
 
/lp/american-medical-association/causative-factors-for-suicide-attempts-by-overdose-in-epileptics-ZU0W1I0REv
Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1989.00520460041011
Publisher site
See Article on Publisher Site

Abstract

Abstract • We investigated possible causative factors for the high epileptic suicide rate by reviewing the cases of 22 patients with idiopathic epilepsy found among 711 patients hospitalized for a suicide attempt by overdose. Suicide attempts occurred with increased seizure activity in one epileptic; otherwise, no relationships were found with seizure-related variables. When matched by age, sex, and race with 44 nonepileptic controls from the same population, the epileptics had more borderline personality disorders with multiple impulsive suicide attempts (45.5% vs 13.6%), more psychotic disturbances, including command hallucinations (31.8% vs 9.1%), fewer adjustment disorders (18.2% vs 45.5%), and a comparable frequency of depression (13.6% vs 25%). We conclude that suicide attempts in epileptics are primarily associated with interictal psychopathologic factors, such as borderline personality disorder and psychosis, rather than with specific psychosocial stressors, seizure variables, or anticonvulsant medications. References 1. Barraclough B. Suicide and epilepsy . In Reynolds E, Trimble MR, eds. Epilepsy and Psychiatry . New York, NY: Churchill Livingstone Inc; 1981:72-76. 2. Mathews WS, Barabas G. Suicide and epilepsy: a review of the literature . Psychosomatics . 1981;22:515-524.Crossref 3. Hawton K, Fagg J, Marsack P. Association between epilepsy and attempted suicide . J Neurol Neurosurg Psychiatry . 1980;43:168-180.Crossref 4. MacKay A. Self-poisoning: a complication of epilepsy . Br J Psychiatry . 1979;134:277-282.Crossref 5. Robertson MM, Trimble MR, Townsend HRA. Phenomenology of depression in epilepsy . Epilepsia . 1987;28:364-372.Crossref 6. Diehl LW. Epilepsie und Suizid . Psychiatr Neurol Med Psychol . 1986;38:625-633. 7. Sato T. The prognosis of epileptic seizures: review of the literatures . Fol Psychiatr Neurol Jpn . 1977;31:279-289. 8. Mendez MF. Psychopathology in epilepsy, prevalence, phenomenology and management . Int J Psychiatry . 1988;18:193-210.Crossref 9. Delay J, Deniker P, Barande R. Le suicide des epileptique . Encephale . 1957;46:401-436. 10. Gunn J. Affective and suicidal symptoms in epileptic prisoners . Psychol Med . 1973;3:108-114.Crossref 11. Mendez MF, Cummings JL, Benson DF. Depression in epilepsy, significance and phenomenology . Arch Neurol . 1986;43:766-770.Crossref 12. Jensen I. Temporal lobe epilepsy: late mortality in patients treated with unilateral temporal lobe resections . Acta Neurol Scand . 1975;52:374-380.Crossref 13. Brent DA. Overrepresentation of epileptics in a consecutive series of suicide attempters seen at a children's hospital, 1978-1983 . J Acad Child Psychiatry . 1986;25:242-246.Crossref 14. Monk M. Epidemiology of suicide . Epidemiol Rev . 1987;9:51-69. 15. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 16. Pike MC, Morrow RH. Statistical analysis of patient-control studies in epidemiology: factor under investigation on all-or-none variable . Br J Prev Soc Med . 1970;24:42-44. 17. Prudhomme C. Epilepsy and suicide . J Nerv Ment Dis . 1941;94:722-731.Crossref 18. Zielinski JJ. Epilepsy and mortality rate and cause of death . Epilepsia . 1974;15:191-201.Crossref 19. Iivanainen M, Lehtimen J. Causes of death in institutionalized epileptics . Epilepsia . 1979;30:485-492.Crossref 20. Henriksen PB, Juul-Jensen F, Lund M. Mortality of epileptics . In: Brackenridge RDC, ed. Life Assurance Medicine . London, England: Pitman Ltd., 1970:139-148. 21. Krohn W. Causes of death among epileptics . Epilepsia . 1963;4:315-321.Crossref 22. Whitlock FA. Suicide and physical illness . In Roy A, ed. Suicide . Baltimore, Md: Williams & Wilkins; 1986:151-170. 23. Suicide and epilepsy . Br Med J . 1980;281:530. Editorial.Crossref 24. Batzel LW, Dodrill CB. Emotional and intellectual correlates of unsuccessful suicide attempts in people with epilepsy . J Clin Psychol . 1986;42:699-702.Crossref 25. Williams D. The structure of emotions reflected in epileptic experiences . Brain . 1956;79:29-67.Crossref 26. Ferrari M, Barabas G, Mathews W. Psychologic and behavioral disturbance among epileptic children treated with barbiturate anticonvnlsants . Am J Psychiatry . 1983;140:112-113. 27. Tucker GJ, Price TRP, Johnson VB, McAllister T. Phenomenology of temporal lobe dysfunction: a link to atypical psychosis: a series of cases . J Nerv Ment Dis . 1986;174:348-356.Crossref 28. Gudmundsson G. Epilepsy in Iceland: a clinical and epidemiological investigation . Acta Neurol Scand . 1966;25( (suppl) ):1-124. 29. Rutter M, Graham P, Yule W. The prevalence of psychiatric disorder in neuro-epileptic children . In: Rutter M, Graham P, Yule W. A Neuropsychiatric Study in Childhood: Clinics in Developmental Medicine . London, England: Heineman Medical Book Ltd; 1979;35:175-185. 30. Pond DA, Bidwell BH. A survey of epilepsy in 14 general practices, II: social and psychological aspects . Epilepsia . 1959;60:285-299.Crossref 31. Lindsay J, Ounsted C, Richards P. Longterm outcome in children with temporal lobe seizures, III: psychiatric aspects in childhood and adult life . Dev Med Child Neurol . 1979;21:630-636.Crossref 32. Ervin F, Epstein RW, King HE. Behavior of epileptic and nonepileptic patients with 'temporal spikes.' Arch Neurol Psychiatry . 1955;74:488-497.Crossref 33. McKenna PJ, Kane JM, Parrish K. Psychiatric syndromes in epilepsy . Am J Psychiatry . 1985;142:895-903. 34. Dongier1 S. Statistical study of clinical and electroencephalographic manifestations of 536 psychotic episodes occurring in 516 epileptics between clinical seizures . Epilepsia . 1959/60;1:117-142.Crossref 35. Betts TA. Depression, anxiety and epilepsy . In: Reynolds EH, Trimble MR, eds. Epilepsy and Psychiatry . New York, NY: Churchill Livingstone Inc; 1981:60-71. 36. Hancock JC, Bevilacqua AR. Temporal lobe dysrhythmia and impulsive or suicidal behavior . South Med J . 1971;64:1189-1193.Crossref 37. Anastassopoulos G, Kokkini D. Suicidal attempts in psychomotor epilepsy . Behav Neuropsychiatry . 1969;1:11-16. 38. Engel J Jr, Kuhl DE, Phelps ME, Mazziotta JC. Interictal cerebral glucose metabolism in partial epilepsy and its relation to EEG changes . Ann Neurol . 1982;12:510-517.Crossref 39. Adamec RE, Stark-Adamec C. Limbic Kindling in animal behavior: implications for human psychopathology associated with complex partial seizures . Biol Psychiatry . 1983;18:269-293. 40. Weil AA. Depressive reactions associated with temporal lobe-uncinate seizures . J Nerv Ment Dis . 1955;121:505-510.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Oct 1, 1989

References