The clinical correlates of suicidal ideation in Parkinson’s disease

Abstract

IntroductionSuicidal ideation is increased in Parkinson's disease (PD) patients. The possible relationship between parkinsonian motor and non-motor symptoms and suicidal ideation in PD is unknown. The aim of the study was to evaluate suicidal ideation in patients with PD in a controlled study specifically designed to identify the clinical correlates of PD suicidal ideation. MethodsWe consecutively enrolled 100 patients with PD, 76 patients with psoriasis and 80 healthy subjects. Motor symptoms and complications were evaluated by using the International Parkinson and Movement Disorder Society-Unified Parkinson's Disease Rating Scale. Non-motor symptoms were evaluated by means of the Non-Motor Symptoms assessment scale for PD. All patients also underwent a psychiatric evaluation that included the administration of the Columbia-Suicide Severity Rating Scale. ResultsSuicidal ideation was present in 31% of PD patients, 16% of patients with psoriasis and 2% of healthy controls. PD patients showing suicidal ideation have more frequent motor complications, more severe non-motor symptoms and a higher perceived disability than patients without suicidal ideation. Suicidal ideation correlated with the presence of motor complications as well as with non-motor symptom severity, perceived disability severity and the presence of psychiatric disorders. ConclusionsOur findings showed that suicidal ideation is increased in PD patients compared with healthy controls and patients with psoriasis and that several clinical PD features, including motor complications and non-motor symptoms, are associated with suicidal ideation in PD. The results suggest a multi-factorial origin of PD suicidal ideation.