Increased suicide risk and clinical correlates of suicide among patients with Parkinson's disease |
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| Affiliation: | 1. Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea;2. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA;3. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea;4. Clinical Nurse Specialist, Department of Neurology, Asan Medical Center, Republic of Korea;5. Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;1. Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia;2. Work, Health and Wellbeing Unit, Population Health Research Centre, School of Health & Social Development, Deakin University, Melbourne, Australia;3. Turning Point, Monash University, Melbourne, Australia;4. Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia;5. Orygen National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia;6. Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia;7. Centre for Brain and Mental Health Research, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia;1. Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center for Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan;2. The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden;3. Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;4. Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujades, 42, Sant Boi de Llobregat, Barcelona 08830, Spain;5. Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, 28029 Madrid, Spain;6. Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala S-751 85, Sweden;7. Child Study Center, Yale University Medical School, New Haven, CT 06520, USA;8. Säter Forensic Psychiatric Clinic, Säter S-783 27, Sweden;1. Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Queensland, Australia;2. School of Psychiatry, University of New South Wales, Sydney, Australia;3. Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, Australia;4. Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia |
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| Abstract: | ![]()
IntroductionParkinson's disease (PD) is a debilitating, neurodegenerative condition frequently complicated by psychiatric symptoms. Patients with PD may be at higher risk for suicide than the general population, but previous estimates are limited and conflicting. The aim of this study is to estimate the suicide rate based on the clinical case registry and to identify risk factors for suicide among patients diagnosed with PD.MethodsThe target sample consisted of 4362 patients diagnosed with PD who were evaluated at a general hospital in Seoul, South Korea, from 1996 to 2012. The standardized mortality ratio for suicide among PD patients was estimated. In order to identify the clinical correlates of suicide, case-control study was conducted based on retrospective chart review. The 29 suicide cases (age: 62.3 ± 13.7 years; females: 34.5%) were matched with 116 non-suicide controls (age: 63.5 ± 9.2 years; females 56.9%) by the year of initial PD evaluation.ResultsThe SMR for suicide in PD patients was 1.99 (95% CI 1.33–2.85). Mean duration from time of initial diagnosis to suicide among cases was 6.1 ± 3.5 years. Case-control analysis revealed that male, initial extremity of motor symptom onset, history of depressive disorder, delusion, any psychiatric disorder, and higher L-dopa dosage were significantly associated with suicide among PD patients. Other PD-related variables such as UPDRS motor score were not significantly associated with death by suicide.ConclusionSuicide risk in PD patients is approximately 2 times higher than that in the general population. Psychiatric disorders, and also L-dopa medication need further attention with respect to suicide. |
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| Keywords: | Parkinson's disease Suicide Risk factors Psychiatric disorder |
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