#7079 Sociodemographic and clinical risk factors for suicidal ideation and suicide attempt in functional/dissociative seizures and epilepsy: a large cohort study

<h3>Background</h3> People with epilepsy and people with functional/dissociative seizures (FDS) are at elevated risk of suicide. Suicidal ideation and suicide attempts (collectively referred to as suicidality hereafter) are strong predictive factors of suicide death. Several risk factors for suicidality in epilepsy have been identified. On the other hand, evidence on the correlates of suicidality in FDS is scarce, with non-systematic reports from small samples. <h3>Objective</h3> To conduct the first study systematically examining risk factors for first episodes of suicidal ideation and suicide attempt in people with FDS. For comparison, to study them also in a cohort of people with epilepsy. <h3>Methods</h3> Retrospective cohort study from the UK’s largest tertiary mental health care provider (South London and Maudsley Hospital NHD Foundation Trust), with linked national admission data from the Hospital Episode Statistics (HES). Participants were 2383 people with a primary or secondary diagnosis of FDS or epilepsy attending between 01/01/2007 and 18/06/2021. Outcomes were a first report of suicidal ideation and a first hospital admission for suicide attempt (ICD-10 X60-X84). Demographic and clinical risk factors were assessed using multivariable bias reduces binomial-response generalised linear models. <h3>Results</h3> In both groups, ethnic minorities had significantly reduced odds of hospitalisations following a suicide attempt (OR: 0.45 – 0.49). Disorder-specific risk factors were gender, age, and comorbidity profile. In FDS, both genders had similar risk of suicidality; younger age was a risk factor for both outcomes (OR: 0.16 – 1.91) and a diagnosis of Depression or Personality Disorders was associated with higher odds of reporting suicidal ideation (OR: 1.91 and 3.01 respectively). In epilepsy, females had higher odds of being hospitalised following suicide attempt (OR: 1.64). Age had a significant quadratic association with both outcomes (OR: 0.88 – 1.06). A Substance Abuse Disorder was associated to higher suicidal ideation (OR: 2.67) whilst Developmental Disorders lowered the risk (OR: 0.16 – 0.24). <h3>Conclusions</h3> This is the first study systematically reporting risk factors for suicidality in people with FDS. Results for the large epilepsy cohort complement previous studies and will be useful in future meta-analyses.