title: Suicidal risk, affective dysphoric disorders, and quality-of-life perception in patients with focal refractory epilepsy.
abstract: OBJECTIVE
  We aim to study the frequency of (suicidal ideation) in patients with focal refractory epilepsy and its possible association with factors such as perceived QOL (quality of life) and ASDD (affective somatoform dysphoric disorder) using the 2007 ILAE proposal to classify affective disorders of epilepsy.
  
  
  METHODS
  A total sample of 82 patients was divided into two groups depending on the presence of suicidal risk: (A) study group - with suicidal risk and (B) control group - without suicidal risk. Questionnaires, scales, interviews, and clinical charts were evaluated by professionals with expertise in neurology and epileptology (RAM and AGA), psychiatry (AGE), and neuropsychology (FGR). Suicidal risk was evaluated with the M.I.N.I. (Mini-International Neuropsychiatric Interview) suicidal module that specifies the current suicidal risk based on scores. Quality of life was evaluated with the Quality of Life in Epilepsy Inventory - 31 (QOLIE-31) survey. Logistic regression was conducted to ascertain if ASDD and QOL significantly predicted suicidal risk. The results were considered statistically significant when the p-value was <0.05.
  
  
  RESULTS
  Suicidal risk was present in 33 (40.3%) patients. It was classified as severe in 31.7% of the patients, and it was only present in cases with temporal lobe epilepsy (p=0.002). More than half (52%) of patients with ASDD had risk of suicide (p=0.006). The presence of ASDD was found to be a risk factor for suicidal risk (OR=3.86; IC=1.3-12.2). Patients with suicidal risk had a lower QOL score compared with patients without suicidal risk (57.8±16.9 vs. 46.0±18.2; p<0.05), and an affected QOL significantly increased suicidal risk (OR=2.9; CI=1.3-7.8). Multivariate analysis demonstrated that an impaired QOL (OR=2.2) and the presence of ASDD (OR=4.1) significantly increased the probability of having suicidal risk (x(2)=13.6; OR=5.2; p=0.009).
  
  
  CONCLUSIONS
  Affective somatoform dysphoric disorder and low QOL perception increase, independently, the risk of suicide.
authors.affiliation: National Institute of Neurology, Havana, Cuba. Electronic address: reneandrade1970@yahoo.es.
authors.forename: Rene
authors.initials: R
authors.lastname: Andrade-Machado
authors.affiliation: National Institute of Neurology, Antioquia, Colombia.
authors.forename: Manuela
authors.initials: M
authors.lastname: Ochoa-Urrea
authors.affiliation: Mental Health Centre, Envigado, Colombia.
authors.forename: Arlety
authors.initials: A
authors.lastname: Garcia-Espinosa
authors.affiliation: National Institute of Neurology, Antioquia, Colombia.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Benjumea-Cuartas
authors.affiliation: National Institute of Neurology, Havana, Cuba.
authors.forename: Aisel
authors.initials: A
authors.lastname: Santos-Santos
mesh_terms: D000328:Adult; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D010465:Perception; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Depressive disorder; Dysphoric disorder; Epilepsy; Interictal symptoms; Quality of life; Suicidal risk