Patients with Parkinson’s disease are two times more likely to commit suicide than people from the general population, according to data from a Taiwanese population-based study.
Importantly, this increased risk of self-inflicted death was found to be independent of socioeconomic status, dementia, and the presence of other mental disorders, such as depression.
According to researchers, these findings highlight the importance of incorporating mental healthcare and socioenvironmental interventions as part of the primary care of patients with Parkinson’s.
The findings were reported in the study, “Risk of Suicide Among Patients With Parkinson Disease,” published in the journal JAMA Psychiatry.
At a global scale, the risk of suicide tends to be higher among older adults than it is in any other age group. Parkinson’s disease, one of the most common neurodegenerative disorders among the elderly, causes physical impairments and is associated with psychiatric symptoms such as depression and anxiety.
Adding to the association between mental disorders and suicide, the physical limitations caused by Parkinson’s, as well as the increased risk of self-inflicted death among older people, are a “call for attention to the likelihood of suicide in patients with Parkinson’s,” the researchers wrote.
Now, researchers from Taiwan reported the findings of a large, nationwide, population-based study that aimed to assess and compare the risk of suicide among Parkinson’s patients with that of people from the general population.
The team assessed the incidence of self-inflicted death in 35,891 people with Parkinson’s — 17,482 women and 18,409 mean, with a mean age of 72.5 — and 143,557 individuals from the general Taiwanese population, who served as controls. The control group comprised 69,928 women and 73,629 men, whose mean age also was 72.5 years.
The number of suicides in both groups was determined by linking data stored by Taiwan’s National Health Insurance between 2002 and 2016 to that stored in the Taiwan Death Registry between 2005 and 2016. Statistical analyses were then used to calculate the risk of suicide in both groups.
All patients included in the analyses were diagnosed with Parkinson’s between 2005 and 2014, and followed up until 2016. Each was matched with four random individuals from the general population, who had the same sex, age, and lived in the same geographical region.
Over the course of the follow-up, which lasted approximately five years in both groups, 151 patients with Parkinson’s and 300 individuals from the general population died by suicide.
Statistical analyses revealed that the risk of suicide among patients was more than twice that seen in controls, even after investigators adjusted data to account for the individuals’ socioeconomic status, dementia, and other possible health conditions. This increased risk of suicide among patients remained nearly the same after investigators performed further data adjustments to account for mental disorders.
Additional analyses showed that patients who committed suicide tended to be slightly younger (mean of 74 vs. 76 years) and to live in high urban areas (55.6% vs. 45.3%), compared with those from the general population who also died by suicide. The incidence of depression (9.9% vs. 5%) and other mental disorders (8% vs. 3.7%) also was found to be higher in the group of patients who took their own lives, compared with controls.
Among those who took their own lives, Parkinson’s patients were more likely to adopt jumping as a method of suicide than those from the general population (13.9% vs. 5.3%).
“We found that suicide was about 2 times more frequent in patients with PD [Parkinson’s disease] than in the general population. Although comorbidity with mental disorders contributed partially to their suicide risk elevations, PD in itself was a potent determinant of suicide,” the researchers wrote.
“Integrating mental health care into primary care and PD specialty care, along with socioenvironmental interventions, may help decrease the risk of suicide in patients with” Parkinson’s, they concluded.
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