Wednesday, March 29, 2023

Two new, ground-breaking research papers, from authors in the UK and Mexico published for World Encephalitis Day 22nd February 2023, have identified that Encephalitis patients are at a high risk of suicide and self-harm. 

The UK paper titled ‘Mental health outcomes of encephalitis’, an international web-based study, surveyed 445 respondents from 31 countries and found that 37.5% of survivors of Encephalitis reported they had thought about or attempted suicide

The Mexican paper ‘Suicidal thoughts and behaviors in Anti-Nmdar Encephalitis: Psychopathological features and clinical outcomes’ published in the Journal of Neuropsychiatry and Clinical Neurosciences, gained data from 120 patients and found that 12.5% of patients had suicidal behaviours during early stages of the illness with nearly half carrying out a suicide attempt.

Both papers have been released in association with the Encephalitis Society to help raise awareness of World Encephalitis Day which takes place on 22nd February 2023. 

Dr Ava Easton, CEO of the Encephalitis Society and co-author on both papers said: “These impactful and important research papers raise awareness that suicidality can be a not uncommon and serious manifestation of encephalitis in the early stages as a result of the illness, during relapses, and perhaps later in people’s journey of recovery.

She added, “We want anyone affected by encephalitis and mental health problems, including thoughts of suicide and self-harm, to know that symptoms are often highly treatable and help and support are available from the Encephalitis Society wherever they live in the world.”

“World Encephalitis Day is a focal point for our global community who have been affected or impacted by Encephalitis. On this very important day we want to project unity, common ground and offer support while we raise awareness.”

A 2020 study in Denmark found that suicide rates in patients diagnosed with encephalitis to be nearly double that of people without the diagnosis of a neurological disorder.

What is Encephalitis?

Encephalitis is an inflammation of the brain.  It can occur at any age, in any part of the world and is caused either by infection, usually viral, or by a person’s own immune system going wrong.  There are over 5,00,000 reported cases of encephalitis around the world each year with mortality up to 40% depending on the cause. 

In many countries, Encephalitis has a higher incidence than motor neuron disease, bacterial meningitis and multiple sclerosis and affects one person every minute globally, yet 77% of people are not aware of what it is.  This lack of awareness, leads to delays in diagnosis, treatment and poorer outcomes for patients.  The symptoms of encephalitis vary but can include flu-like illness, head pain, drowsiness, uncharacteristic behaviour, frank psychosis, difficulty in controlling movements and speech and seizures (fits). Aged patients may come to the hospital with sickness resembling dementia.

In India, outbreaks of acute encephalitis syndrome (AES) pose a major public health problem, affecting thousands of people every year. Japanese encephalitis virus, scrub typhus and dengue virus are the leading cause of AES in the country. In India, AES is often unrecognized and under-reported. Overall, incidence of encephalitis is suspected to be around 3,00,000 cases a year. Among individuals who develop acute encephalitis syndrome, case fatality is as high as 30% and long-term neurological or psychiatric condition can occur in 30-50% of patients.

More dramatic is the long-term brain damage that 20% of these patients suffer leading to Epilepsy, memory loss, loss of attention, personality changes, paralysis, sensory loss such as loss of hearing or vision, depression, speech and movement difficulties. Nearly 80% of the patients who survive develop some degree of neurological sequelae in the form of behavioural problems, low intellect in school and routine tasks.

The 10th anniversary of World Encephalitis Day on Wednesday, 22nd February, aims to raise awareness of encephalitis (inflammation of the brain caused either by infection (examples include Covid-19, measles or the cold-sore virus) or by a person’s own immune system going wrong), an often-devastating neurological condition which can leave survivors with a permanent brain injury.

The Encephalitis Society is calling for more awareness that suicidality can be a not uncommon and serious manifestation of encephalitis; that swift diagnosis and treatment, along with careful risk assessment during encephalitis can reduce suicidal thoughts and behaviours in many cases (reducing patient death and disability). Anyone affected by encephalitis and any associated mental health problems including thoughts of suicide and self-harm to know that symptoms are often highly treatable and help and support are available from the Encephalitis Society wherever they live in the world.