Magnitude and associated factors of suicidal ideation and attempt among people with epilepsy attending outpatient treatment at primary public hospitals in northwest Ethiopia: a multicentre cross-sectional study.

OBJECTIVE: This study aimed to assess magnitude and associated factors of suicidal ideation and attempt among people with epilepsy attending outpatient treatment at primary public hospitals, northwest Ethiopia using suicide module of World Mental Health Survey initiative version of the WHO, composite international diagnostic interview. DESIGN: Multicentre-based cross-sectional study was used. SETTING: Data were collected using face to face interview from patients with epilepsy who attended outpatient treatment at primary public hospitals at northwest Ethiopia. PARTICIPANTS: Adult patients with epilepsy (n=563) who came to attend outpatient treatment during the study period were included in the study using systematic random sampling technique. OUTCOME MEASURES: Suicidal ideation, suicidal attempt and factors associated with suicidal ideation and attempt. RESULTS: The overall magnitude of suicidal ideation and attempt was 26.5% and 12.6%, respectively. Being woman adjusted OR ((AOR)=1.68, 95% CI 1.09 to 3.23), living alone (AOR=2.4, 95% CI 1.47 to 3.92), divorced/widowed/(AOR=2.2, 95% CI 1.09 to 7.8), family history of suicidal attempt (AOR=2.53, 95% CI 1.34 to 4.79), depression (AOR=3.18, 95% CI 1.85 to 5.45), anxiety (AOR=2.92, 95% CI 1.68 to 5.09), comorbid medical illness (AOR=2.60, 95% CI 1.17 to 5.82) and poor social support (AOR=2.35, 95% CI 1.26 to 4.40) were statistically associated with suicidal ideation. Depression (AOR=4.87, 95% CI 2.56 to 9.28) living alone (AOR=2.66, 95% CI 1.62 to 5.41), family history of committed suicide (AOR=2.80, 95% CI 1.24 to 6.39), taking medication for mental illness (AOR=2.17, 95% CI 1.06 to 4.46), hazardous alcohol use (AOR=2.10, 95% CI 1.05 to 4.23) were statistically associated with suicidal attempts at a p value <0.05. CONCLUSION: This study showed that the magnitude of suicidal ideation and attempt was high among people with epilepsy. Being woman, living alone, having depression and anxiety, single, divorced/widowed in marital status, family history of suicidal attempt and poor social support were statistically associated with suicidal ideation. Having depression, living alone, family history of suicide attempt, hazardous alcohol use and drug taking for mental illness were statistically associated with suicidal attempt. Based on the findings of this study early screening, detection and management of suicide were recommended in people with epilepsy.

The effect of COVID-19 pandemic on seizure control and self-reported stress on patient with epilepsy.

OBJECTIVES: The objective of the study was to assess if patients with epilepsy (PWE) experienced an increase in seizure frequency and self-reported stress during the COVID-19 pandemic. METHODS: This is a cross-sectional study conducted in Saudi Arabia in April 2020. An electronic self-administered questionnaire was distributed to PWE via their treating neurologist. The variables included were demographic and baseline clinical characteristics (age, gender, living situation, occupational status, type of epilepsy, duration of epilepsy, number of antiepileptic medications (AEDs), presence of known psychiatric illness, and use of psychiatric medications), their seizure control in the month prior to the pandemic, perceived stress during this period of time, sleep changes, compliance changes, and change in seizure control during the pandemic. RESULTS: A total of 156 patients completed the questionnaire, with 29.5% reporting an increase in seizure frequency. Additionally, 59.4% reported an increase in self-reported stress and 71.2% experienced a significant change in their sleep during this period. Higher baseline seizure frequency, more AEDs, noncompliance, increase in self-reported stress, and sleep changes are the significant factors associated with increase in seizure frequency during the pandemic. CONCLUSION: Identifying high-risk patients for seizure recurrence is important in order to provide them with adequate support to reduce such risk.