Suicidal and death ideation in Parkinson's disease

• Published in: Movement disorders 2008-08, Vol.23 (11), p.1573-1579
• Main Authors: Nazem, Sarra, Siderowf, Andrew D., Duda, John E., Brown, Gregory K., Ten Have, Tom, Stern, Matthew B., Weintraub, Daniel
• Format: Article
• Language: English
• Subjects: Aged; Analysis of Variance; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Depression; Disruptive, Impulse Control, and Conduct Disorders; Female; Humans; Male; Medical sciences; Middle Aged; Neurology; Parkinson Disease - psychology; Parkinson's disease; Psychiatric Status Rating Scales; Regression Analysis; Risk Factors; Severity of Illness Index; suicide; Suicide - psychology; Suicide - statistics & numerical data; Suicide, Attempted - psychology; Suicide, Attempted - statistics & numerical data
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.22130

Parkinson's disease (PD) is a chronic, disabling illness affecting primarily the elderly and is associated with a high prevalence of depression. Although these are known risk factors for suicidal and death ideation, little is known about the prevalence and correlates of such ideation in PD. A convenience sample of 116 outpatients with idiopathic PD at two movement disorders centers were administered a modified Paykel Scale for suicidal and death ideation, as well as an extensive psychiatric, neuropsychological, and neurological battery. Univariate and multivariate logistic regression models were used to determine the correlates of suicidal or death ideation. Current death ideation (28%) or suicide ideation (11%) were present in 30% of the sample, and 4% had a lifetime suicide attempt. On univariate logistic regression analysis, increasing severity of depression (odds ratio = 2.92, 95% CI 2.01–4.24, P < 0.001), impulse control disorder (ICD) behaviors sometime during PD (odds ratio = 6.08, 95% CI 1.90–19.49, P = 0.002), and psychosis (odds ratio = 2.45, 95% CI 1.05–5.69, P = 0.04) were associated with either ideation. On multivariate logistic regression analysis, only increasing severity of depressive symptoms (odds ratio = 2.76, 95% CI 1.88–4.07, P < 0.001) predicted suicidal or death ideation. In conclusion, active suicidal or death ideation occurs in up to one‐third of PD patients. Comorbid psychiatric disorders, more than PD‐related disease variables, are associated with this ideation, highlighting the need for a comprehensive approach to the clinical care of PD patients. © 2008 Movement Disorder Society