Liverpool Adverse Events Profile Predictive of Suicidality Risk in Drug-Resistant Epilepsy

epilepsy brain EEG
epilepsy brain EEG
The Liverpool Adverse Events Profile questionnaire may be a useful tool for identifying people with epilepsy who may be at higher risk for suicidality.

The Liverpool Adverse Events Profile (LAEP)21-item self-report questionnaire may be a useful tool for identifying people with epilepsy (PWE) who may be at higher risk for suicidality, according to a study published in Seizure: European Journal of Epilepsy.1

Epilepsy increases the risk for suicidality. In PWE, the lifetime prevalence of suicidal ideation is twice that of people without epilepsy and those with epilepsy are 3 times more likely to attempt suicide than people without epilepsy.2-5 Although factors related to seizures, such as high frequency and early onset, can be a risk factor for suicide,6 depression and other psychiatric comorbidities have a more significant impact on suicidality in PWE.5,7  

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Depression occurs more frequently in PWE when their seizures are not under control,4 such as in people with drug-resistant epilepsy (PWDRE), and depression itself also disturbs seizure control.8

A high score on the LAEP questionnaire is associated with depression, and for PWE, this may be due to an increase in adverse events with antiepileptic drugs (AED). Thus, researchers investigated whether clinicians can discern a high risk for suicidality in 144 PWDRE by referring to the LAEP.1

They found that among this study population, 36 PWDRE (25.0%) had a high risk for suicidality. A total LAEP score of greater than 45 or checking off a severe score (score 3 or 4) on more than 8 items appeared to be associated with a high risk for suicidality.

The authors concluded that, “The LAEP may inform a high risk of suicidality in PWDRE. Referring to this, clinicians can discern suicidal problems in their epilepsy clinics.”1


1. Kwon OH, Park SP. Usefulness of the Liverpool adverse events profile for predicting a high risk of suicidality in people with drug-resistant epilepsy. Seizure. 2019;67:65-70.

2. Tellez-Zenteno JF, Patten SB, Jette N, Williams J, Wiebe S. Psychiatric comorbidity in epilepsy: a population-based analysis. Epilepsia. 2007;48:2336-2344.

3. Christensen J, Vestergaard M, Mortensen PB, Sidenius P, Agerbo E. Epilepsy and risk of suicide: a population-based case-control study. Lancet Neurol. 2007;6:693-698.

4. Kwon OY, Park SP. Frequency of affective symptoms and their psychosocial impact in Korean people with epilepsy: a survey at two tertiary care hospitals. Epilepsy Behav. 2013;26:51-56.

5. Seo JG, Lee JJ, Cho YW, et al. Suicidality and its risk factors in Korean people with epilepsy: a MEPSY study. J Clin Neurol. 2015;11:32-41.

6. Nilsson L, Ahlbom A, Farahmand BY, Asberg M, Tomson T. Risk factors for suicide in epilepsy: a case control study. Epilepsia. 2002;43:644-651.

7. Lim HW, Song HS, Hwang YH, et al. Predictors of suicidal ideation in people with epilepsy living in Korea. J Clin Neurol. 2010;6:81-88.

8. Hitiris N, Mohanraj R, Norrie J, Sills GJ, Brodie MJ. Predictors of pharmacoresistant epilepsy. Epilepsy Res. 2007;75:192-196.