Abstracts

Rationale:
Death by suicide disproportionately impacts individuals with epilepsy compared to the general population. To inform targeted interventions, detailed understanding of those with epilepsy who die by suicide is needed. Here, we examined case summaries of suicide in people with epilepsy, characterizing them by demographics, medical comorbidities, and manner of death to understand how individuals with epilepsy die by suicide in Ontario, Canada.
Method:
Case summaries of all autopsies conducted by the Ontario Forensic Pathology Service in Ontario, Canada between January 1, 2014 and June 1, 2016 were retrospectively screened using a language processing script for decedents with a history of epilepsy or seizures.  Case summaries of individuals with a history of epilepsy or seizures were manually reviewed for epilepsy, cause of death, and evidence of suicidal intent.
Results:
From 15229 death summaries, 485 cases with a history of epilepsy or seizures were identified. Review of these summaries indicated death by suicide in 15 individuals with epilepsy including 7 (47%) who died by hanging and 3 (20%) who died by falling from a height. The median (25th, 75th percentile) age at death was 45 years (31, 53); 40% (n=6) were female. A history of depression, bipolar disorder, schizophrenia, psychosis, admission to hospital under the mental health act or a previous suicide attempt was documented in 10 (67%) case summaries.
Conclusion:
Based on review of case summaries, demographic characteristics of individuals with epilepsy who die by suicide appear to mirror suicide deaths in the general population. Comorbid mental health disorders are relatively common in individuals with epilepsy who die by suicide. Comprehensive epilepsy management should include screening for mental health conditions and suicidality and provision of resources to support people with epilepsy determined to be at risk.
Funding:
:The Michael Bahen Chair in Epilepsy Research at the University of Toronto