Introduction: Epilepsy is a chronic brain disease that carries a high psycho-pathological risk. Depression is the most common psychiatric comorbidity in patients with epilepsy and is of great importance considering that it is associated with an impaired quality of life of patients, suicidal behavior, potential occurrence of adverse effects of anticonvulsant drugs, pharmacoresistance and worse outcome of surgical treatment of epilepsy. Suicide, as a phenomenon, is the main cause of premature death in epilepsy patients, and it is known that the risk of suicide is the highest in people with a depressed mood. The association between epilepsy and mood disorders is based on various factors, including common neuroanatomical and neurochemical principles such as the involve-ment of mesiotemporal structures and the psychotropic effects of many anticon-vulsant drugs. Despite the fact that depression is significantly present in patients with epilepsy, the clinical picture of depressive symptomatology can be very inconspicuous, and in the conditions of daily clinical work, its timely recogni-tion is often difficult. In clinical practice, it is very difficult to define the main factors that contribute to the appearance of psychiatric disorders in patients with epilepsy, given that most possible predictors of depression are subject to modi-fication by various other factors. Objectives: Determining the frequency of depressive symptoms and suicidal behavior in patients with epilepsy compared to a healthy control group that was matched in basic sociodemographic characteristics with the study group, then analyzing possible risk factors from several domains, including clinical charac-teristics of epilepsy and sociodemographic factors, the influence of anxiety symptoms on suicidal behavior in depressed patients with epilepsy, and finally, the influence of depressive symptoms and suicidal behavior on the quality of life of patients. Methods: The study was conducted as a cross-sectional study and included 131 patients with epilepsy (aged 18-74 years) who were consecutively included during outpatient visits at the Clinic of Neurology and the Polyclinics of the University Clinical Center of Vojvodina (UKCV). In order to compare the obtained results of the frequency of depressive symptoms and suicidal behavior in the studied population of patients with epilepsy, a control group was also included, which included 62 people from the general healthy population, that was matched in basic sociodemographic characteristics with the study group. In order to collect data, structured scales were created for the clinical characte-ristics of the disease and sociodemographic data, and numerous psychometric scales for assessing depression and suicidal behavior were used to assess the consistency of the respondents’ answers, and with the aim of checking the reliability of the information obtained. Results: The study included 131 patients with epilepsy, as well as 62 people from the general healthy population; it was determined that depressive symptoms (51.1% versus 22.6%, p=0.000), as well as suicidal thoughts-in the last month (18.3% versus 3.2%, p=0.004), as well as during of life (19.1 % versus 6.5 %, =0.022) more often represented in the group of patients with epilepsy. In the group of patients with epilepsy in whom depressive symptoms were registered, the most frequent category is those who manifest serious depression (49.25%). When it comes to current antidepressant therapy, about 18% of respondents take this therapy, which is significantly less compared to the number of those who are currently depressed. Predictive factors associated with depressive symptoms are: side effects of anticonvulsant drugs (OR=3.01; 95% CI:1.09–8.32), present history of febrile seizures (OR=3.75; 95% CI:1 .07–13.11), female gender (OR=2.16; 95% CI: 0.984–4.73), as well as the combination of simple focal+complex focal+ GTK epileptic seizures (OR=7.32; 95% CI: 0.830–64.59). Predictive factors associated with suicidal behavior are: anticonvulsant polytherapy (OR=8.91; 95% CI:1.64–48.56), current depressive symptomatology (OR=1.15; 95% CI:1.06– 1.24) and anxiety symptoms (OR=1.11; 95% CI: 1.02–1.20). Conclusion: 1. In patients with epilepsy, there is an increased frequency of depressive symptoms and suicidal behavior compared to the general population of healthy individulas. 2. Predisposing clinical characteristics of the disease for the development of depressive symptoms in patients with epilepsy are: high frequency of epileptic seizures in the previous year, focal complex epileptic seizures as well as a combination of simple focal, complex focal and secondary generalized epileptic seizures, anticonvulsant polytherapy, presence of adverse effects of anticonvul-sant therapy, history of febrile seizures. 3. Female gender is a significant predisposing sociodemographic factor for the development of depressive symptoms in patients with epilepsy. 4. Adverse effects of anticonvulsant drugs, present history of febrile seizures, female gender, as well as the combination of simple focal + complex focal + GTK epileptic seizures represent unique, independent predictors of depressive symptomatology in patients with epilepsy. 5. Predisposing clinical characteristics of the disease for the development of suicidal behavior in patients with epilepsy are: anticonvulsant polytherapy, presence of adverse effects of anticonvulsant therapy, history of febrile seizu-res, previous suicidal thoughts, previous suicide attempts, current depression, previous depression, previous antidepressant therapy, current antidepressant therapy, anxiety symptoms. 6. Sociodemographic factors are not identified as potentially predisposing indicators for suicidal behavior in patients with epilepsy. 7. Anticonvulsant polytherapy, current depressive symptomatology and anxiety symptoms are unique, independent predictors of suicidal behavior in patients with epilepsy. 8. Anxiety symptoms represent a significant predictive factor for suicidal behavior in depressed patients with epilepsy. 9. The presence of depressive symptomatology and suicidal behavior in patients with epilepsy is a significant predictor of worse quality of life in patients with epilepsy.