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Hallucinatory experiences in individuals with seizures are markers of high risk for mental health disorders and suicidal behaviour, according to researchers from Ireland.
They said they had identified a “particularly strong relationship” between hallucinations and suicide attempts in individuals with seizures.
“It’s important to recognise that hallucinations don’t simply reflect abnormal electrical activity in individuals with epilepsy”
As a result, the study authors called on clinicians working with individuals with seizures to “routinely ask about hallucinatory experiences”.
The team, from Trinity College Dublin and the Royal College of Surgeons in Ireland, said it was the first time the mental health significance of hallucinations had been shown in those with a history of seizures.
The study findings showed that 8% of individuals with a history of seizures reported hallucinations, including experiences of hearing or seeing things that are not based in reality, they said.
Most importantly, of that 8%, 65% also met criteria for one or more mental health disorders and 53% had one or more suicide attempt, they noted in the journal Epilepsia.
As part of one of the longest running studies of mental health in the general population, researchers assessed a wide range of physical and mental health factors in 15,000 people living in the UK.
The authors said hallucinations were known to occur in some adults with seizures but might be erroneously viewed only as ‘incidental’ symptoms of abnormal electrical activity in the brain.
“It’s important in epilepsy clinics to ask about hallucinations – and where someone endorses these symptoms, to carefully examine their mental state”
They argued that the findings showed the symptoms were not just incidental in people with seizures and that they were important markers of risk for mental ill health and for suicidal behaviour.
Senior author Dr Ian Kelleher, research associate professor of psychiatry at Trinity, said: “People with epilepsy are known to be at increased risk of suicide. But among individuals with seizures, it’s hard to pick out who is most at risk.
“What this research shows is that people with seizures who report hallucinations are a particularly high-risk group for suicidal behaviour – about half of these individuals had one or more suicide attempt.
“So, it’s important in epilepsy clinics to ask about hallucinations – and where someone endorses these symptoms, to carefully examine their mental state,” he said.
Study author Kathryn Yates, from the RCSI, added: “It’s not surprising that individuals with seizures have a higher rate of hallucinations – almost any disease that affects the brain is likely to increase risk of hallucinations.
“However, it’s important to recognise that hallucinations don’t simply reflect abnormal electrical activity in individuals with epilepsy; they’re important markers of risk for mental health problems.”