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Published on: May 22, 2010
Suicidal Ideation in Spinocerebellar Ataxia
Levi Peppel1, Ruo-Yah Lai1, Christian Rummey1
1Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai).
Objective:
Suicidal ideation has not been extensively studied in spinocerebellar ataxias (SCAs). The authors examined whether individuals with SCAs have increased suicidal ideation and related factors.
Methods:
The authors studied patients with genetically confirmed SCAs enrolled in the Clinical Research Consortium for the Study of Cerebellar Ataxia cohort, examining the percentages of patients with SCA subtypes 1, 2, 3, and 6 who reported suicidal ideation and comparing findings with nationally representative data from the National Survey on Drug Use and Health (NSDUH). Clinical characteristics that may contribute to suicidal ideation in SCAs, including age, disease duration, sex, ataxia severity, depression, and SCA subtype, were also studied.
Results:
Suicidal ideation was present among 12% of 769 patients with SCAs and 4.3% of individuals in the general population recorded in the NSDUH. Compared with individuals in the general population, SCA patients had higher odds of suicidal ideation (OR=2.72). Compared with patients with SCA without suicidal ideation, patients with SCA and suicidal ideation had a longer disease duration (mean±SD=13.1±8.2 years vs. 11.2±9.4 years), more severe ataxia (Scale for the Assessment and Rating of Ataxia mean score=15.9±8.6 vs. 12.9±7.6), and more severe depression. Having suicidal ideation at baseline significantly increased the odds of suicidality later in the disease course (OR=58.73, 95% CI=36.00-98.40).
Conclusions:
Suicidal ideation was more prevalent among patients with SCAs than in the general population. The findings of this study underscore the importance of continuous suicidal risk screening among individuals with SCAs and the need for effective depression management.
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