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Suicidal ideation in a European Huntington's disease population

Hubers, Anna A M; van Duijn, Erik; Roos, Raymund A C; Craufurd, David; Rickards, Hugh; Bernhard Landwehrmeyer, G; van der Mast, Rose C; Giltay, Erik J; , and Petersén, Åsa LU , et al. (2013) In Journal of Affective Disorders 151(1). p.58-248
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... (More)

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.

LIMITATIONS: 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.

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keywords
Depression, Europe, Female, Heterozygote, Humans, Huntington Disease, Male, Middle Aged, Prevalence, Proportional Hazards Models, Psychiatric Status Rating Scales, Psychological Tests, Suicidal Ideation, Suicide, Attempted
in
Journal of Affective Disorders
volume
151
issue
1
pages
11 pages
publisher
Elsevier
external identifiers
  • scopus:84888645373
ISSN
1573-2517
DOI
10.1016/j.jad.2013.06.001
language
English
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yes
id
fce5a45a-a4a9-4d30-9902-3c18f2661108
date added to LUP
2017-04-19 18:32:41
date last changed
2018-03-25 04:35:51
@article{fce5a45a-a4a9-4d30-9902-3c18f2661108,
  abstract     = {<p>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.</p><p>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.</p><p>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.</p><p>LIMITATIONS: 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.</p><p>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.</p>},
  author       = {Hubers, Anna A M and van Duijn, Erik and Roos, Raymund A C and Craufurd, David and Rickards, Hugh and Bernhard Landwehrmeyer, G and van der Mast, Rose C and Giltay, Erik J and ,  and Petersén, Åsa and Reimer, Jan and Widner, Håkan},
  issn         = {1573-2517},
  keyword      = {Depression,Europe,Female,Heterozygote,Humans,Huntington Disease,Male,Middle Aged,Prevalence,Proportional Hazards Models,Psychiatric Status Rating Scales,Psychological Tests,Suicidal Ideation,Suicide, Attempted},
  language     = {eng},
  number       = {1},
  pages        = {58--248},
  publisher    = {Elsevier},
  series       = {Journal of Affective Disorders},
  title        = {Suicidal ideation in a European Huntington's disease population},
  url          = {http://dx.doi.org/10.1016/j.jad.2013.06.001},
  volume       = {151},
  year         = {2013},
}