These authors report a doubling in the rate of suicide in PD patients compared to controls... this feels pretty high and I cannot think of many, if any, patients I know of that have committed suicide. My impression is that it is more common in the atypical parkinsonisms. The authors do acknowledge this and say that the previous literature is mixed... some studies suggest higher risk and some lower risk. There is likely to be wide variability region to region and social support network and professional support (specialist nurses, doctors and support groups) are likely to be strong determinants... the results of such studies may not be generalisable to all populations...
Parkinsonism Relat Disord. 2016 Sep 6. pii: S1353-8020(16)30331-5. doi: 10.1016/j.parkreldis.2016.09.006. [Epub ahead of print]
Lee T, Lee HB, Ahn MH, Kim J, Kim MS, Chung SJ, Hong JP.
Parkinson's disease (PD) is a debilitating, neurodegenerative condition frequently complicated by psychiatric symptoms. Patients with PD may be at higher risk for suicide than the general population, but previous estimates are limited and conflicting. The aim of this study is to estimate the suicide rate based on the clinical case registry and to identify risk factors for suicide among patients diagnosed with PD.
The target sample consisted of 4362 patients diagnosed with PD who were evaluated at a general hospital in Seoul, South Korea, from 1996 to 2012. The standardized mortality ratio for suicide among PD patients was estimated. In order to identify the clinical correlates of suicide, case-control study was conducted based on retrospective chart review. The 29 suicide cases (age: 62.3 ± 13.7 years; females: 34.5%) were matched with 116 non-suicide controls (age: 63.5 ± 9.2 years; females 56.9%) by the year of initial PD evaluation.
The SMR for suicide in PD patients was 1.99 (95% CI 1.33-2.85). Mean duration from time of initial diagnosis to suicide among cases was 6.1 ± 3.5 years. Case-control analysis revealed that male, initial extremity of motor symptom onset, history of depressive disorder, delusion, any psychiatric disorder, and higher L-dopa dosage were significantly associated with suicide among PD patients. Other PD-related variables such as UPDRS motor score were not significantly associated with death by suicide.
Suicide risk in PD patients is approximately 2 times higher than that in the general population. Psychiatric disorders, and also L-dopa medication need further attention with respect to suicide.