Suicidal and death ideation in Parkinson's disease

Authors

  • Sarra Nazem BA,

    1. Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Andrew D. Siderowf MD,

    1. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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  • John E. Duda MD,

    1. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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  • Gregory K. Brown PhD,

    1. Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Tom Ten Have PhD,

    1. Center for Clinical and Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Matthew B. Stern MD,

    1. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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  • Daniel Weintraub MD

    Corresponding author
    1. Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    3. Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
    4. Mental Illness Research, Education and Clinical Center (MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
    • 3535 Market St., Room 3003, Philadelphia, Pennsylvania 19104
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Abstract

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

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