Sara Melin , Torbjörn Tomson , Olafur Sveinsson , Tomas Andersson , Sofia Carlsson , Christian Rück , Karin Wirdefeldt
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We reviewed their medical records, death certificates, and autopsy records to validate the cause of death and epilepsy diagnosis, as well as collect information on suicide method and circumstances. After validation we calculated the incidence rates by age and sex and standardized mortality ratios (SMRs) with 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>Overall suicide incidence was 40.0/100,000 person-years (95 % CI 33.0–47.9). Incidence was highest in age 45 to 64 years (61.3, 95 % CI 46.4–79.1) and appeared higher in men than in women with epilepsy. Compared to the general population, individuals with epilepsy had twice the risk of suicide (SMR 2.03 CI 1.67–2.45) and the excess risk appeared more pronounced in women (SMR 2.70 CI 1.92–3.68) than in men (SMR 1.80 CI 1.40–2.26). Intoxication (50 %) was the most common method, followed by hanging, cutting weapons and guns (25 % combined).</div></div><div><h3>Significance</h3><div>Our results confirm that suicide is overrepresented in individuals with epilepsy, especially in middle age. Incidence was higher in men but the SMR was higher among women, suggesting that the effect of epilepsy on suicide risk is greater for women than for men. Identifying subgroups that are particularly vulnerable is important for suicide prevention.</div></div>","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Incidence, methods and circumstances of suicide in epilepsy: A population-based study in Sweden\",\"authors\":\"Sara Melin , Torbjörn Tomson , Olafur Sveinsson , Tomas Andersson , Sofia Carlsson , Christian Rück , Karin Wirdefeldt\",\"doi\":\"10.1016/j.yebeh.2024.110106\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>Persons with epilepsy have a higher risk of suicide compared to the general population, but limited data makes it unclear how extensive this risk is and who is most vulnerable. Our study aimed to explore the incidence of suicide among persons with epilepsy in Sweden, and compare to the general population. To facilitate prevention, we also wanted to examine methods and circumstances of suicide.</div></div><div><h3>Methods</h3><div>We identified all individuals with a diagnosis of epilepsy (ICD G40) in the Swedish Patient Register between 1998 and 2005 who were alive in 2006 (n = 60,952). Among them, 190 cases of suicide were recorded in the National Cause of Death Register during follow-up 2006 to 2011. We reviewed their medical records, death certificates, and autopsy records to validate the cause of death and epilepsy diagnosis, as well as collect information on suicide method and circumstances. After validation we calculated the incidence rates by age and sex and standardized mortality ratios (SMRs) with 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>Overall suicide incidence was 40.0/100,000 person-years (95 % CI 33.0–47.9). Incidence was highest in age 45 to 64 years (61.3, 95 % CI 46.4–79.1) and appeared higher in men than in women with epilepsy. Compared to the general population, individuals with epilepsy had twice the risk of suicide (SMR 2.03 CI 1.67–2.45) and the excess risk appeared more pronounced in women (SMR 2.70 CI 1.92–3.68) than in men (SMR 1.80 CI 1.40–2.26). Intoxication (50 %) was the most common method, followed by hanging, cutting weapons and guns (25 % combined).</div></div><div><h3>Significance</h3><div>Our results confirm that suicide is overrepresented in individuals with epilepsy, especially in middle age. Incidence was higher in men but the SMR was higher among women, suggesting that the effect of epilepsy on suicide risk is greater for women than for men. 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引用次数: 0
摘要
目的与普通人群相比，癫痫患者有更高的自杀风险，但由于数据有限，目前还不清楚这种风险有多大，以及哪些人最容易自杀。我们的研究旨在探讨瑞典癫痫患者的自杀发生率，并与普通人群进行比较。为了便于预防，我们还希望研究自杀的方法和环境。方法我们在瑞典患者登记册中识别了所有在1998年至2005年间被诊断为癫痫（ICD G40）且在2006年还活着的患者（n = 60,952）。其中有 190 例自杀病例记录在 2006 年至 2011 年的全国死因登记册中。我们查阅了他们的医疗记录、死亡证明和尸检记录，以验证死因和癫痫诊断，并收集有关自杀方式和情况的信息。经过验证后，我们按年龄和性别计算了发病率和标准化死亡率（SMRs），并得出了 95 % 的置信区间（CI）。结果总体自杀发病率为 40.0/100,000 人年（95 % CI 33.0-47.9）。45至64岁年龄段的发病率最高（61.3，95 % CI 46.4-79.1），男性癫痫患者的发病率高于女性。与普通人群相比，癫痫患者的自杀风险是普通人群的两倍（SMR 2.03 CI 1.67-2.45），女性（SMR 2.70 CI 1.92-3.68）比男性（SMR 1.80 CI 1.40-2.26）的自杀风险更高。中毒（50%）是最常见的自杀方式，其次是上吊、切割武器和枪支（合计 25%）。男性的自杀率较高，但女性的自杀率较高，这表明癫痫对女性自杀风险的影响大于男性。识别特别易受影响的亚群体对预防自杀非常重要。
Incidence, methods and circumstances of suicide in epilepsy: A population-based study in Sweden
Objective
Persons with epilepsy have a higher risk of suicide compared to the general population, but limited data makes it unclear how extensive this risk is and who is most vulnerable. Our study aimed to explore the incidence of suicide among persons with epilepsy in Sweden, and compare to the general population. To facilitate prevention, we also wanted to examine methods and circumstances of suicide.
Methods
We identified all individuals with a diagnosis of epilepsy (ICD G40) in the Swedish Patient Register between 1998 and 2005 who were alive in 2006 (n = 60,952). Among them, 190 cases of suicide were recorded in the National Cause of Death Register during follow-up 2006 to 2011. We reviewed their medical records, death certificates, and autopsy records to validate the cause of death and epilepsy diagnosis, as well as collect information on suicide method and circumstances. After validation we calculated the incidence rates by age and sex and standardized mortality ratios (SMRs) with 95 % confidence intervals (CI).
Results
Overall suicide incidence was 40.0/100,000 person-years (95 % CI 33.0–47.9). Incidence was highest in age 45 to 64 years (61.3, 95 % CI 46.4–79.1) and appeared higher in men than in women with epilepsy. Compared to the general population, individuals with epilepsy had twice the risk of suicide (SMR 2.03 CI 1.67–2.45) and the excess risk appeared more pronounced in women (SMR 2.70 CI 1.92–3.68) than in men (SMR 1.80 CI 1.40–2.26). Intoxication (50 %) was the most common method, followed by hanging, cutting weapons and guns (25 % combined).
Significance
Our results confirm that suicide is overrepresented in individuals with epilepsy, especially in middle age. Incidence was higher in men but the SMR was higher among women, suggesting that the effect of epilepsy on suicide risk is greater for women than for men. Identifying subgroups that are particularly vulnerable is important for suicide prevention.
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