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Suicide among people with epilepsy: A population-based analysis of data from the U.S. National Violent Death Reporting System, 17 states, 2003–2011

  • Niu Tian
    Correspondence
    Corresponding author at: Centers for Disease Control and Prevention, Division of Population Health, Epilepsy Program, 4770 Buford Highway, NE, Mailstop F-78, Atlanta, GA 30341, United States. Tel.: +1 770 488 5679; fax: +1 770 488 5486.
    Affiliations
    Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States
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  • Wanjun Cui
    Affiliations
    Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States
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  • Matthew Zack
    Affiliations
    Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States
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  • Rosemarie Kobau
    Affiliations
    Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States
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  • Katherine A. Fowler
    Affiliations
    Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States
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  • Dale C. Hesdorffer
    Affiliations
    GH Sergievsky Center and Mailman School of Public Health, Columbia University, New York, NY 10032, United States
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      Highlights

      • We examined suicide burden among people with epilepsy in 17 U.S. states (2003–2011).
      • The estimated average annual suicide rate in those with epilepsy was 16.89/100,000 persons.
      • Suicide risk in those with epilepsy was 22% higher than in the general population.
      • Suicides occurred more often in residence, among those 40–49 years old, and by poisoning.
      • Reducing exposure to poisons, Mental Health First Aid may prevent suicides.

      Abstract

      Objective

      This study analyzed suicide data in the general population from the U.S. National Violent Death Reporting System (NVDRS) to investigate suicide burden among those with epilepsy and risk factors associated with suicide and to suggest measures to prevent suicide among people with epilepsy.

      Methods

      The NVDRS is a multiple-state, population-based, active surveillance system that collects information on violent deaths including suicide. Among people 10 years old and older, we identified 972 suicide cases with epilepsy and 81,529 suicide cases without epilepsy in 17 states from 2003 through 2011. We estimated their suicide rates, evaluated suicide risk among people with epilepsy, and investigated suicide risk factors specific to epilepsy by comparing those with and without epilepsy. In 16 of the 17 states providing continual data from 2005 through 2011, we also compared suicide trends in people with epilepsy (n = 833) and without epilepsy (n = 68,662).

      Results

      From 2003 through 2011, the estimated annual suicide mortality rate among people with epilepsy was 16.89/100,000 per persons, 22% higher than that in the general population. Compared with those without epilepsy, those with epilepsy were more likely to have died from suicide in houses, apartments, or residential institutions (81% vs. 76%, respectively) and were twice as likely to poison themselves (38% vs. 17%) (P < 0.01). More of those with epilepsy aged 40–49 died from suicide than comparably aged persons without epilepsy (29% vs. 22%) (P < 0.01). The proportion of suicides among those with epilepsy increased steadily from 2005 through 2010, peaking significantly in 2010 before falling.

      Significance

      For the first time, the suicide rate among people with epilepsy in a large U.S. general population was estimated, and the suicide risk exceeded that in the general population. Suicide prevention efforts should target people with epilepsy 40–49 years old. Additional preventive efforts include reducing the availability or exposure to poisons, especially at home, and supporting other evidence-based programs to reduce mental illness comorbidity associated with suicide.

      Keywords

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