Causative factors for suicide attempts by overdose in epileptics
M. F. Mendez, D. J. Lanska, R. Manon-Espaillat and T. H. Burnstine
Department of Neurology, University Hospitals of Cleveland, Ohio.
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.
