Suicide in the epilepsies: a meta-analytic investigation of 29 cohorts

Objectives. Suicide in epilepsy is a major cause of death and is very often underestimated. We conducted a meta-analysis to compare data reported in representative studies of suicide in epilepsy with data for the general population. Methods. We searched the Index Medicus until 2005 through MedLine. We also searched the World Health Statistics Annual to ascertain the suicide rates in the age groups indicated in the studies on epileptic patients for specific years and country. Results. We selected 29 studies comprising 50,814 patients, 187 of whom committed suicide. Results obtained for each study were processed together to calculate the mean number of suicides per 100,000 individuals suffering from epilepsy for each year. Conclusions. Our meta-analysis shows that suicide in patients with epilepsy is more frequent than in the general population. Nevertheless, a number of cohorts of epileptic patients had a suicide rate lower than that of the general population. Possible explanations for this heterogeneous trend and risk factors are discussed.