Suicidality and non-fatal self-injury behaviors among people living with epilepsy attending neurology clinic at Zewditu memorial hospital and Amanuel mental specialized hospital, Addis Ababa, Ethiopia: A cross-sectional study

Background: Suicidality, suicidal ideation, suicide planningand nonfatal self-harm behaviors are more frequent among people living with epilepsy(PLWE) than the general population. The increased risk of suicidality and nonfatal self-harm behaviors and associated factors among people with epilepsy varies across sociodemographic and disease-related factors as well as comorbid psychiatric conditions. This study aimed to determine the magnitude of suicidality and nonfatalself-injury behaviors and identify theirassociated factors among PWE seeking medical care at Amanuel Mental Specialized Hospital and Zewditu Memorial Hospital, Addis Ababa, Ethiopia, in 2021. Methods: A facility-based cross-sectional study with 345 randomly selected epileptic patients who attended the outpatient neurology treatment service at Amanuel Mental Specialized Hospital and Zewditu Memorial Hospital was conducted from 15 December 2020 to 15 February 2021. The WHO composite international diagnostic interview (CIDI) was used to assess suicidality, depression, and epilepsy-related factors. The association between outcome variables and selected independent variables was tested using a logistic regression model. Results: The magnitudes of suicidal ideation, suicide planning, and nonfatal self-injury behavior among people living with epilepsy were 21.2%, 18.3%, and 11.9%,respectively. Living alone, poor social support, and comorbid depression were significantly associated with suicidal ideation, suicide planning, and nonfatal self-injury behavior. Individuals who were taking two or more anti-epileptic drugs also showed a statistical association with suicidal ideation (AOR 0.45, 95% CI=.21,.97; p=0.041) and suicide planning (AOR 0.36, 95% CI=.162,.815; p=0.014). Conclusions: The prevalence of suicidal ideation and nonfatal self-injury behavior among PWE was high among Ethiopian epileptic patients in a hospital setting. Routine screening and proper intervention for comorbid depression as well as avoiding polytherapy might prevent suicidality and nonfatal self-injury behavior. Strong social support also helped prevent suicide and improve quality of life.