Suicide risk is about two times higher in patients with Parkinson’s disease than the general population, even after adjusting for physical and mental comorbidities, according to a study published Wednesday in JAMA Psychiatry.
“Approximately 40% to 50% of patients with [Parkinson’s] are affected by depression, and 30% to 40% are affected by anxiety disorders,” wrote Ying-Yeh Chen, M.D., Sc.D., of the Taipei City Psychiatric Center in Taiwan and colleagues. “In addition to the long-established associations between mental disorders and suicide, the physical limitations caused by [Parkinson’s] and the well-known increased risk of suicide in older persons call for attention to the likelihood of suicide in [these] patients.”
Chen and colleagues conducted a cohort study using Taiwan’s National Health Insurance data, identifying 35,891 patients who received a Parkinson’s disease diagnosis between 2005 and 2014, with follow-up through 2016. Each patient with Parkinson’s was matched with four control participants (those who had not been diagnosed with Parkinson’s disease), for a total control cohort of 143,577. The researchers also analyzed whether the participants had been diagnosed with dementia, depression, or another mental disorder within one year prior to or after the onset of Parkinson’s. Data on suicides were obtained from the Taiwan Death Registry from 2005 to 2016.
In patients with Parkinson’s, the 11-year cumulative incidence of suicide was 66.6 per 100,000, compared with 32.3 per 100,000 among the control participants.
“The suicide risk elevation in [Parkinson’s] was only partially explained by comorbidity with depression and other mental disorders,” the authors wrote, adding that Parkinson’s in itself markedly escalated the risk of suicide.
Compared with the control participants who died by suicide, patients with Parkinson’s who died by suicide were more likely to be younger (the mean age among patients with Parkinson’s was 74 compared with 76 in the control participants) and reside in urban areas, the authors found.
The authors concluded by pointing to potential intervention measures, such as enhancing family and community connectedness for this population. “Integrating mental health care into primary care and [Parkinson’s] specialty care, along with socioenvironmental interventions, may help decrease the risk of suicide in patients with [Parkinson’s],” they wrote.
For related information, see the Psychiatric News article “Phone CBT Effective for Patients With Parkinson’s Disease.”
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