Suicidal ideation in Huntington disease: The role of comorbidity

• Published in: Psychiatry research 2011-08, Vol.188 (3), p.372-376
• Main Authors: Wetzel, Heather H, Gehl, Carissa R, Dellefave–Castillo, Lisa, Schiffman, Judith F, Shannon, Kathleen M, Paulsen, Jane S
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Anxiety - epidemiology; Anxiety - psychology; Biological and medical sciences; Comorbidity; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Depression - epidemiology; Depression - psychology; Disability Evaluation; Female; Genetic; Humans; Huntington Disease - epidemiology; Huntington Disease - psychology; Logistic Models; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurodegenerative; Neurology; Odds Ratio; Organic mental disorders. Neuropsychology; Predictive Value of Tests; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Severity of Illness Index; Suicidal Ideation; Suicide
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2011.05.006

Abstract Huntington disease (HD) is a neurodegenerative condition characterized by cognitive impairments, motor abnormalities, and psychiatric disturbance. An increased risk for suicide has been documented. The majority of HD research has focused on cognitive and motor features of HD; the implications of psychiatric manifestations have received less consideration. Recent studies have sought to identify the stages of HD in which patients are at increased risk to experience suicidal ideation, though no study has examined possible risk factors for suicidality. The current study examines the presence of psychiatric comorbidity and its involvement in suicidal ideation. Suicidal ideation was examined in 1941 HD patients enrolled in the Huntington Study Group. Of those, 19% ( N = 369) endorsed current suicidal ideation. Logistic regression analyses indicated that depression/anxiety and aggression/irritability are significant predictors of suicidal ideation. In a subsample with the greatest suicidal ideation, alcohol and drug abuse were also predictive. It is recommended that all individuals with HD (specifically those with features of depression, aggression, substance abuse) have routine suicide assessment; further research is needed to understand the high rate of suicide in HD.