title: Suicidal and death ideation in Parkinson's disease.
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.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Sarra
authors.initials: S
authors.lastname: Nazem
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Siderowf
authors.forename: John E
authors.initials: JE
authors.lastname: Duda
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Brown
authors.forename: Tom
authors.initials: T
authors.lastname: Ten Have
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Stern
authors.forename: Daniel
authors.initials: D
authors.lastname: Weintraub
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D003863:Depression; D007174:Disruptive, Impulse Control, and Conduct Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data