Highlights
- •We explored 4362 Parkinson's disease patients enrolled in a clinical registry.
- •Standardized mortality ratio for suicide was 1.99, out of 29 suicide observed.
- •Retrospective case-control study was conducted to identify correlates of suicide.
- •Depression, delusion and higher L-dopa dosage were associated with suicide.
- •We suggest that suicide risk in PD is higher than that of the general population.
Abstract
Introduction
Parkinson'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.
Methods
The 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.
Results
The 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.
Conclusion
Suicide 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.
Keywords
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Article info
Publication history
Published online: September 06, 2016
Accepted:
September 5,
2016
Received in revised form:
July 19,
2016
Received:
April 19,
2016
Identification
Copyright
© 2016 Elsevier Ltd. All rights reserved.
