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The clinical correlates of suicidal ideation in Parkinson’s disease

      Highlights

      • Suicidal ideation is increased in Parkinson's disease.
      • Suicidal ideation has a multi-factorial origin in Parkinson's disease.
      • Perceived disability plays has a key role in parkinsonian suicidal ideation.

      Abstract

      Introduction

      Suicidal ideation is increased in Parkinson's disease (PD) patients. The possible relationship between parkinsonian motor and non-motor symptoms and suicidal ideation in PD is unknown. The aim of the study was to evaluate suicidal ideation in patients with PD in a controlled study specifically designed to identify the clinical correlates of PD suicidal ideation.

      Methods

      We consecutively enrolled 100 patients with PD, 76 patients with psoriasis and 80 healthy subjects. Motor symptoms and complications were evaluated by using the International Parkinson and Movement Disorder Society-Unified Parkinson's Disease Rating Scale. Non-motor symptoms were evaluated by means of the Non-Motor Symptoms assessment scale for PD. All patients also underwent a psychiatric evaluation that included the administration of the Columbia-Suicide Severity Rating Scale.

      Results

      Suicidal ideation was present in 31% of PD patients, 16% of patients with psoriasis and 2% of healthy controls. PD patients showing suicidal ideation have more frequent motor complications, more severe non-motor symptoms and a higher perceived disability than patients without suicidal ideation. Suicidal ideation correlated with the presence of motor complications as well as with non-motor symptom severity, perceived disability severity and the presence of psychiatric disorders.

      Conclusions

      Our findings showed that suicidal ideation is increased in PD patients compared with healthy controls and patients with psoriasis and that several clinical PD features, including motor complications and non-motor symptoms, are associated with suicidal ideation in PD. The results suggest a multi-factorial origin of PD suicidal ideation.

      Keywords

      Abbreviations:

      C-SSRS (Columbia Suicide Severity Rating Scale), FAB (Frontal Assessment Battery), H&Y (Hoehn and Yahr scale), IDPS (Italian Perceived Disability Scale), LEDDs (levodopa-equivalent daily dose), MoCA (Montreal Cognitive Assessment), MDS (UPDRS), Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (NMSS), Non-Motor Symptoms assessment scale for Parkinson's disease (PD:Parkinson's disease)
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