title: Suicidal ideation in a European Huntington's disease population.
abstract: BACKGROUND
  Previous studies indicate increased prevalences of suicidal ideation, suicide attempts, and completed suicide in Huntington's disease (HD) compared with the general population. This study investigates correlates and predictors of suicidal ideation in HD.
  
  
  METHODS
  The study cohort consisted of 2106 HD mutation carriers, all participating in the REGISTRY study of the European Huntington's Disease Network. Of the 1937 participants without suicidal ideation at baseline, 945 had one or more follow-up measurements. Participants were assessed for suicidal ideation by the behavioural subscale of the Unified Huntington's Disease Rating Scale (UHDRS). Correlates of suicidal ideation were analyzed using logistic regression analysis and predictors were analyzed using Cox regression analysis.
  
  
  RESULTS
  At baseline, 169 (8.0%) mutation carriers endorsed suicidal ideation. Disease duration (odds ratio [OR]=0.96; 95% confidence interval [CI]: 0.9-1.0), anxiety (OR=2.14; 95%CI: 1.4-3.3), aggression (OR=2.41; 95%CI: 1.5-3.8), a previous suicide attempt (OR=3.95; 95%CI: 2.4-6.6), and a depressed mood (OR=13.71; 95%CI: 6.7-28.0) were independently correlated to suicidal ideation at baseline. The 4-year cumulative incidence of suicidal ideation was 9.9%. Longitudinally, the presence of a depressed mood (hazard ratio [HR]=2.05; 95%CI: 1.1-4.0) and use of benzodiazepines (HR=2.44; 95%CI: 1.2-5.0) at baseline were independent predictors of incident suicidal ideation, whereas a previous suicide attempt was not predictive.
  
  
  CONCLUSIONS
  As suicidal ideation was assessed by only one item, and participants were a selection of all HD mutation carriers, the prevalence of suicidal ideation was likely underestimated.
  
  
  CONCLUSIONS
  Suicidal ideation in HD frequently occurs. Assessment of suicidal ideation is a priority in mutation carriers with a depressed mood and in those using benzodiazepines.
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. a.a.m.hubers@lumc.nl
authors.forename: Anna A M
authors.initials: AA
authors.lastname: Hubers
authors.forename: Erik
authors.initials: E
authors.lastname: van Duijn
authors.forename: Raymund A C
authors.initials: RA
authors.lastname: Roos
authors.forename: David
authors.initials: D
authors.lastname: Craufurd
authors.forename: Hugh
authors.initials: H
authors.lastname: Rickards
authors.forename: G
authors.initials: G
authors.lastname: Bernhard Landwehrmeyer
authors.forename: Rose C
authors.initials: RC
authors.lastname: van der Mast
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Giltay
mesh_terms: D003863:Depression / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006579:Heterozygote; D006801:Humans; D006816:Huntington Disease / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data
keywords: Cohort studies; Huntington's disease; Psychopathology; Psychopharmacology; Suicidal ideation