Gender differences in risk factors of suicidal behavior in epilepsy.

The current study was performed to determine possible gender differences among risk factors for suicidal behavior in epilepsy. A special rating scale for assessment of suicidality was designed. The risk of suicide attempt was higher in epilepsy with concomitant diagnoses of organic affective disorder (F=06.3, ICD-10) and cognitive impairment (F=07.62, ICD-10). Risk was higher among females than males. Early age of epilepsy onset and high frequency of secondary generalized, simple partial, and all seizures were risk factors for suicidality in males, whereas low frequency of complex partial seizures was the risk factor in females. Daily dose of a classic antiepileptic drug was a risk factor for males, whereas daily dose of phenobarbital was a risk factor for both genders. Daily dose of carbamazepine and valproate is inversely correlated with suicidal behaviour in women, but not in men. The results obtained are discussed in the context of a paradigm of gender dimorphism as an indicator of evolution of Homo sapiens.