| Title: |
Suicidality at Epilepsy Diagnosis and Future Treatment Resistance in Adults With Focal Epilepsy |
| Authors: |
Barnard, Sarah N; French, Jacqueline A; Chen, Zhibin; Holmes, Manisha; Hegde, Manu; Altalib, Hamada Hamid; Winawer, Melodie; Sperling, Michael; Jette, Nathalie; Hope, Omotola; Nadkarni, Siddhartha; O’Brien, Terence J; Kuzniecky, Ruben; Lowenstein, Daniel; Kanner, Andres M; Boro, Alexis; Cole, Andrew; Rodriguez, Andy; Gidal, Barry; Abou-Khalil, Bassel; Fureman, Brandy; Alldredge, Brian; Neuray, Caroline; Szabo, Charles; Morrison, Chris; Hesdorffer, Dale; Ficker, David; Gloss, David; Dlugos, Dennis; Faught, Edward; Schmid, Elisabeth; Geller, Eric; Somerville, Ernest; Trinka, Eugen; Cutter, Gary; Jackson, Graeme; Cascino, Gregory; Krauss, Gregory; Worrell, Gregory; Pardoe, Heath; Cloyd, James; Szaflarski, Jerzy; Hixson, John; Pollard, John; Halford, Jonathan; Kang, Joon; Burneo, Jorge; Weisenberg, Judy; Detyniecki, Kamil; Meador, Kimford; Park, Kristen; Marcuse, Lara; Lin, Liu; Brandon, M; Fields, Madeline; Nadkarni, Mangala; Kirschner, Margarita; Bebin, Martina; Devinsky, Orrin; Penovich, Patricia; Kwan, Patrick; Atkinson, Paul; Klein, Pavel; Widdess-Walsh, Peter; Singh, Rani; Kälviäinen, Reeta; Knowlton, Robert; Mintzer, Scott; Haut, Sheryl; Glynn, Simon; Herman, Susan; Glauser, Tracy; Ting, Tricia |
| Source: |
JAMA Neurology, vol 83, iss 4 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2026 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
32 Biomedical and Clinical Sciences (for-2020); 3202 Clinical Sciences (for-2020); Mental Illness (rcdc); Anxiety Disorders (rcdc); Neurodegenerative (rcdc); Neurosciences (rcdc); Suicide (rcdc); Behavioral and Social Science (rcdc); Brain Disorders (rcdc); Mental Health (rcdc); Clinical Research (rcdc); Epilepsy (rcdc); Prevention (rcdc); Serious Mental Illness (rcdc); Depression (rcdc); 3 Good Health and Well Being (sdg); Human Epilepsy Project Investigators |
| Description: |
Importance: Psychiatric disturbances are common in epilepsy and are associated with increased risk of premature mortality, lower quality of life, and poor response to antiseizure medications (ASMs). Objective: To evaluate the role of psychiatric disturbances at the time of epilepsy diagnosis in predicting risk of future treatment resistance in focal epilepsy. Design, Setting, and Participants: The Human Epilepsy Project (HEP) is a prospective, observational, international, and multicenter cohort study with follow-up for up to 6 years. Participants with newly diagnosed focal epilepsy, enrolled within 4 months of initiating ASM treatment, between the ages 18 and 60 years, and without significant other comorbidities were recruited during the open period of 2012 to 2020. Data analysis was performed from January to September 2025. Exposure: Presence of a psychiatric diagnosis. Main Outcomes and Measures: Presence of psychiatric diagnosis (mood/anxiety disorders) measured by Mini International Neuropsychiatric Interview (MINI) and/or suicidality measured by Columbia-Suicide Severity Rating Scale (C-SSRS) at enrollment. Treatment response included the following outcomes: treatment resistant (TR), defined as failure of first 2 adequate ASM trials (ongoing seizures at/above therapeutic doses); treatment sensitive (TS), defined by a minimum period of seizure freedom on first 2 adequate ASM trials (12 months/3-fold greatest pretreatment seizure-free interval, whichever is longer); and indeterminate (neither TR/TS). Results: Of 376 enrolled adults, 347 (median [IQR] age at seizure onset, 33 [23-44] years; 209 female [60.2%]) completed the MINI and C-SSRS at enrollment. Of these individuals, 191 (55%) were TS, 83 (24%) TR, and 73 (21%) indeterminate. The rate of psychiatric disturbance (mood/anxiety disorder; suicidality) at epilepsy diagnosis was 38% (n = 133). Fifty-seven (16%) had mood/anxiety disorder(s) without suicidality, and 75 (22%) expressed suicidality with or without a psychiatric disorder. Suicidality at ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt8x16f1cp; https://escholarship.org/uc/item/8x16f1cp; https://escholarship.org/content/qt8x16f1cp/qt8x16f1cp.pdf |
| DOI: |
10.1001/jamaneurol.2026.0204 |
| Availability: |
https://escholarship.org/uc/item/8x16f1cp; https://escholarship.org/content/qt8x16f1cp/qt8x16f1cp.pdf; https://doi.org/10.1001/jamaneurol.2026.0204 |
| Rights: |
public |
| Accession Number: |
edsbas.6F2F4769 |
| Database: |
BASE |