Top

Journal of Neurology

Published in:

01-06-2018 | Original Communication

Neurological diseases and risk of suicide attempt: a case–control study

Authors: Astrid Eliasen, Kim Peder Dalhoff, Henrik Horwitz

Published in: Journal of Neurology | Issue 6/2018

Abstract

Introduction

Neurological diseases have a profound impact on quality of life. We investigated the risk of suicide attempt in ten neurological diseases.

Methods

Case–control study. Cases were identified from the Danish Poison Information Centre database in the period 2006–2013. The prevalence of ten neurological diagnoses was compared with the prevalence in a randomly sampled age- and gender-matched control group.

Results

We identified 8974 cases of suicidal attempt and 89,740 controls. We found an association between suicide attempt in nine of ten neurological diseases and disease groups, including stroke [odds ratio (OR) 3.1, 95% confidence interval (CI) (2.8–3.6)], Huntington’s disease [OR 8.8, 95% CI (3.2–24.1)], amyotrophic lateral sclerosis [OR 5.0, 95% CI (1.7–14.6)], Parkinson’s disease [OR 2.9, 95% CI (1.8–4.6)], Alzheimer’s disease and other degenerative diseases [OR 4.8, 95% CI (3.1–7.5)], multiple sclerosis [OR 1.5, 95% CI (1.1–2.1)], epilepsy [OR 4.5, 95% CI (4.1–5.0)], hereditary and idiopathic neuropathy [OR 2.2, 95% CI (1.1–4.3)] and myasthenia gravis [OR 4.3, 95% CI (2.0–9.4)].

Conclusion

Nine out of ten chronic neurological diseases were associated with an increased risk of suicide attempt. These data must be considered for clinicians treating this vulnerable group of patients.

Rickards H (2006) Depression in neurological disorders: an update. Curr Opin Psychiatry 19:294–298. https://doi.org/10.1097/01.yco.0000218601.17722.5b CrossRefPubMed

Stenager EN, Madsen C, Stenager E, Boldsen J (1998) Suicide in patients with stroke: epidemiological study. BMJ 316:1206CrossRefPubMedPubMedCentral

Brønnum-Hansen H, Stenager E, Nylev Stenager E, Koch-Henriksen N (2005) Suicide among Danes with multiple sclerosis. J Neurol Neurosurg Psychiatry 76:1457–1459. https://doi.org/10.1136/jnnp.2004.056747 CrossRefPubMedPubMedCentral

Coughlin SS, Sher L (2013) Suicidal behavior and neurological illnesses. J Depress Anxiety Suppl. https://doi.org/10.4172/2167-1044.S9-001 CrossRef

Lee T, Lee HB, Ahn MH et al (2016) Increased suicide risk and clinical correlates of suicide among patients with Parkinson’s disease. Parkinsonism Relat Disord 32:102–107. https://doi.org/10.1016/j.parkreldis.2016.09.006 CrossRefPubMed

Farrer LA, Opitz JM, Reynolds JF (1986) Suicide and attempted suicide in Huntington disease: implications for preclinical testing of persons at risk. Am J Med Genet 24:305–311. https://doi.org/10.1002/ajmg.1320240211 CrossRefPubMed

Jones JE, Hermann BP, Barry JJ et al (2003) Rates and risk factors for suicide, suicidal ideation, and suicide attempts in chronic epilepsy. Epilepsy Behav 4(Suppl 3):S31–S38CrossRefPubMed

Bell GS, Gaitatzis A, Bell CL et al (2009) Suicide in people with epilepsy: how great is the risk? Epilepsia 50:1933–1942. https://doi.org/10.1111/j.1528-1167.2009.02106.x CrossRefPubMed

Center for selvmordsforskning (2014) Statistikbank. http://statistik.selvmordsforskning.dk/. Accessed 1 Dec 2017

10.

Horwitz H, Dalhoff KP, Klemp M et al (2017) The prognosis following amphetamine poisoning. Scand J Public Health. https://doi.org/10.1177/1403494817707634 PubMedCrossRef

11.

Schmidt M, Schmidt SAJ, Sandegaard JL et al (2015) The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol 7:449–490. https://doi.org/10.2147/CLEP.S91125 CrossRefPubMedPubMedCentral

12.

Vandenbroucke JP, von Elm E, Altman DG et al (2014) Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Int J Surg 12:1500–1524. https://doi.org/10.1016/j.ijsu.2014.07.014 CrossRefPubMed

13.

Schisterman EF, Cole SR, Platt RW (2009) Overadjustment bias and unnecessary adjustment in epidemiologic studies. Epidemiology 20:488–495. https://doi.org/10.1097/EDE.0b013e3181a819a1 CrossRefPubMedPubMedCentral

14.

Pearce N (2016) Analysis of matched case-control studies. BMJ 352:i969CrossRefPubMedPubMedCentral

15.

Breslow NE, Day NE (1980) Statistical methods in cancer research. Volume I—the analysis of case-control studies. Chapter 7. Conditional logistic regression for matched sets. In: IARC Scientific Publications. pp 247–279

16.

Joshi P, Song H-B, Lee S-A (2017) Association of chronic disease prevalence and quality of life with suicide-related ideation and suicide attempt among Korean adults. Indian J Psychiatry 59:352–358. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_282_16 CrossRefPubMedPubMedCentral

17.

Stenager EN, Jensen B, Stenager M et al (2011) Suicide attempts in multiple sclerosis. Mult Scler J 17:1265–1268. https://doi.org/10.1177/1352458511401942 CrossRef

18.

Draper BM (2015) Suicidal behavior and assisted suicide in dementia. Int Psychogeriatrics 27:1601–1611. https://doi.org/10.1017/S1041610215000629 CrossRef

19.

Altura KC, Patten SB, Fiest KM et al (2016) Suicidal ideation in persons with neurological conditions: prevalence, associations and validation of the PHQ-9 for suicidal ideation. Gen Hosp Psychiatr. https://doi.org/10.1016/j.genhosppsych.2016.06.006 CrossRef

20.

Mason K, Thygesen LC, Stenager E et al (2012) Evaluating the use and limitations of the Danish National Patient Register in register-based research using an example of multiple sclerosis. Acta Neurol Scand 125:213–217. https://doi.org/10.1111/j.1600-0404.2011.01558.x CrossRefPubMed

21.

Lempert T, Dieterich M, Huppert DBT (1990) Psychogenic disorders in neurology: frequency and clinical spectrum. Acta Neurol Scand 82(5):335–340CrossRefPubMed

22.

Stack S (2000) Suicide: a 15-year review of the sociological literature. Part I: cultural and economic factors. Suicide Life Threat Behav 30:145–162PubMed

23.

Stack S, Kposowa AJ (2011) Religion and suicide acceptability: a cross-national analysis. J Sci Study Relig 50:289–306CrossRefPubMed

Title: Neurological diseases and risk of suicide attempt: a case–control study
Authors: Astrid Eliasen
Kim Peder Dalhoff
Henrik Horwitz
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 6/2018
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-018-8837-4

At a glance: The STEP trials

Springer Medicine

Neurological diseases and risk of suicide attempt: a case–control study

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2018

A novel frameshift variant in the CADASIL gene NOTCH3: pathogenic or not?

Agreement between clinician-rated versus patient-reported outcomes in Huntington disease

Similarities and differences between infantile and early childhood onset vanishing white matter disease

Impaired fasting glucose is associated with unfavorable outcome in ischemic stroke patients treated with intravenous alteplase

Myasthenia gravis and infectious disease

Monoclonal antibodies for migraine: an update