Epilepsy and suicide: a narrative review

The epilepsy represents a challenge for life expectancy and quality of life either for social and relational consequences due to stigma and for the consequences of the disorder itself. Suicidal behaviors are more frequent in the persons with epilepsy than in the general population. In addition to those shared with other chronic diseases, the condition of a person with epilepsy recognizes particular risk factors related to the clinical characteristics, demographic, socioeconomic and relational conditions. The frequent comorbidity with psychiatric disorders, first of all depression, complicates the clinical picture both because of neurobiological underpinnings underlying the two disorders and the negative interaction on the quality of life. The hopelessness is strongly correlated to suicidal ideation and its evaluation can be considered a relevant and reliable tool for measuring suicidal ideation. A careful evaluation of suicidal ideation, taking into account demographic and psychological conditions of patients, as well as clinical, social, economic situations, is warranted. The diagnosis and treatment of the disease has to take into account a bio-psycho-social approach that allows the integration of medical, psychological and social aspects.