Rozpowszechnienie i czynniki związane z myślami samobójczymi u nastolatków z epilepsją leczonych w ugandyjskich szpitalach referencyjnych

BACKGROUND: Epilepsy is associated with an increased risk of suicidality across the lifespan, including during adolescence, a developmental period characterised by heightened psychological vulnerability. Evidence on suicidality among adolescents with epilepsy in sub-Saharan Africa is limited. This study examined the prevalence of suicidality and its correlates among adolescents with epilepsy attending national referral hospitals in Uganda. METHODS: A cross-sectional study was conducted among adolescents aged 10-17 years with clinician-confirmed epilepsy attending Butabika National Mental Referral Hospital and Mulago National Referral Hospital in Kampala. Suicidality and current psychiatric comorbidities were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Coping strategies were measured using the Brief Coping Orientation to Problems Experienced (COPE) and perceived social support using the Multidimensional Scale of Perceived Social Support (MSPSS). Hierarchical multivariable logistic regression was used to examine the incremental contribution of sociodemographic, clinical, psychiatric, coping, and social support domains to suicidality. RESULTS: Nearly one-third (30.5%) reported at least one form of suicidality, most commonly passive suicidal ideation (27.8%). In multivariable analysis, female sex was associated with higher odds of suicidality (aOR 2.20, 95% CI 1.14-4.25), and poor treatment adherence was also associated with increased odds (aOR 2.28, 95% CI 1.09-4.74). Current depression showed the strongest association with suicidal behaviour (aOR 11.18, 95% CI 3.81-32.81). Higher perceived social support was associated with lower odds of suicidality (aOR 0.85, 95% CI 0.75-0.98), suggesting a protective role. Coping strategies were not significantly associated with suicidality after adjustment for clinical and psychiatric factors. CONCLUSIONS: Suicidality is common among adolescents with epilepsy in Uganda. Psychiatric comorbidity, particularly depression, accounts for the greatest proportion of explained variability in suicidal behaviour, while perceived social support provides additional protection. Integrating routine mental health screening and strengthening family and community support within epilepsy care may reduce suicide risk in this vulnerable population.