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Suicidal behavior in prodromal Huntington disease
Jess G Fiedorowicz1, James A Mills, Adam Ruggle
1Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA.
Neuro-Degenerative Diseases
|June 11, 2011
Summary
Individuals with prodromal Huntington disease (HD) face increased suicide risk. A history of suicide attempts and depression are key predictors, suggesting established risk factors apply to early-stage HD.
Area of Science:
- Neuroscience
- Genetics
- Psychiatry
Background:
- Huntington disease (HD) is associated with increased suicide risk.
- Specific risk factors for suicidal behavior in prodromal HD remain unclear.
Purpose of the Study:
- To identify risk factors for suicidal behavior in individuals with prodromal Huntington disease (HD).
- Suicidal behavior is defined as suicide or attempted suicide.
Main Methods:
- Prospective cohort study (PREDICT-HD) including 735 individuals with HD gene expansion and 194 controls.
- Survival analysis assessed risk factors: depression, hopelessness, substance abuse, marital status, gender, and psychiatric history.
Main Results:
- During 3.7 years of follow-up, 1.6% attempted suicide and 0.1% completed suicide; no suicides occurred in controls.
- History of suicide attempts (HR 8.5) and Beck Depression Inventory II score >13 (HR 7.2) were significant predictors.
- Past 2-year incarceration history was also associated with suicidal behavior (HR 12.5).
Conclusions:
- A history of suicide attempts and depression strongly predict suicidal behavior in prodromal HD.
- Established suicide risk factors appear relevant for individuals in the early stages of Huntington disease.
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