Factors associated with suicidal ideation in people with parkinsonism: findings from the PRIME-UK cross-sectional study.

Objective

To assess the frequency, and factors associated with suicidal ideation (SI) in people with parkinsonism (PwP).

Background

Both the neuropsychiatric and motor features, coupled with the incurable progression of parkinsonism, make this population at increased risk of suicide. Whilst a meta-analysis found a pooled prevalence of SI of 22%, frequency of SI and the associated factors vary significantly between studies.

Methods

This single-centre cross-sectional questionnaire study included participants with a diagnosis of idiopathic Parkinson's Disease (PD), and other types of parkinsonism (excluding drug-induced). Participants were considered to have SI if they reported passive or active suicidal thoughts on question 9 of the Beck Depression Inventory. We present descriptive statistics and logistic regression models to estimate associations between PD symptoms, health and demographic measures, and SI.

Results

442 participants were included (66% male, median age 75.9 years (IQR 70.7-81.4). SI was reported by 19% of participants (n = 82; 95%CI 15-22%) Factors associated with SI after adjustment for possible confounders included female sex (OR 1.89; 95%CI 1.16-3.08; p = 0.01), non-iPD parkinsonism (OR 2.70; 95%CI 1.38-5.30; p = 0.004), living in rented accommodation (OR 4.48; 95%CI 2.24-8.94; p < 0.001), higher non-motor symptom (NMS) burden (OR per 1 unit change 1.15; 95%CI 1.09-1.21; p < 0.001) and poorer quality of life (OR per 1 unit change 1.04; 95%CI 1.02-1.05; p < 0.001).

Conclusions

We demonstrated that SI is common in this population. Female gender, non-iPD parkinsonism, higher NMS and rented accommodation were associated with increased odds of SI. Awareness of these associated factors assists clinicians in identifying individuals at higher risk.