Parkinson’s disease ups risk of suicide

Patients with Parkinson’s disease (PD) have a significantly increased risk of suicide compared with the general population, results of a population-based cohort study from Taiwan have shown.

“High suicide rates among older individuals represent a growing concern in many developed countries. Although mental health comorbidities contributed to an increased suicide risk, our study’s findings showed that PD was a potent determinant of suicide,” said the researchers. [JAMA Psychiatry 2020, doi: 10.1001/jamapsychiatry.2020.4001]

“Apart from identifying and treating mental disorders in patients with PD, integrating mental health care into primary care, geriatric care and PD specialty care, along with socioenvironmental interventions, such as home safety assessment to prevent suicide by jumping, may help in decreasing the risk of suicide in these patients,” they suggested.

In the study, data of 35,891 patients (mean age, 72.5 years; male, 51.3 percent) with incident PD diagnosed between January 2002 and December 2014 were extracted from the Taiwan National Health Insurance (NHI) data set, which covers >99 percent of the Taiwanese population, and linked to the Taiwan Death Registry between January 2002 and December 2016. Each patient with PD was matched to four control participants randomly selected from the general population by risk set sampling.

At a median follow-up of 4.95 years and 5.40 years, 151 patients with PD and 300 control participants died as a result of suicide, respectively. The 11-year cumulative suicide incidence was higher in patients with PD than control participants (66.6 per 100,000 vs 32.3 per 100,000).

Patients with vs without PD had an almost 2-fold increase in risk of suicide (hazard ratio, [HR] 1.9; 95 percent confidence interval [Cl], 1.6 to 2.3; p<0.001) after multivariate adjustment of socioeconomic position, medical comorbidities, dementia and mental disorders.

Compared with control participants who died as a result of suicide, patients with PD who died as a result of suicide were significantly younger (p=0.05), and more likely to be residing in urban areas (p=0.03) and have mental disorders (p=0.02). In addition, patients with vs without PD were significantly more likely to adopt jumping as a method of suicide (13.9 percent vs 5.3 percent; p<0.01).