Adults with Parkinson's disease (PD) are twice as likely to engage in suicidal behavior as the general population, results of a large meta-analysis show.
Given that up to half of patients with PD suffer from depression and anxiety, physicians should maintain a "high index of suspicion" for early recognition and management of suicidality, write the investigators, led by Eng-King Tan, MD, of Duke-NUS Medical School in Singapore.
"Management of both medical, such as sleep disorders, and psychosocial risk factors, such as feelings of loneliness, hopelessness, and depressed mood, could be useful in lowering suicide risk in patients with PD," they add.
The study was published online November 13 in JAMA Neurology.
Suicide Risk Neglected in PD?
The analysis included 505,950 patients with PD across 28 cross-sectional, case-control, and cohort studies.
Across 14 studies, the prevalence of suicidal ideation in patients with PD was 22.2% (95% CI, 14.6 - 32.3). In a sensitivity analysis excluding three outliers, the prevalence of suicidal ideation was higher at 24% (95% CI, 19.1 - 29.7).
Across 21 studies, the prevalence of suicidal behavior was "substantial" at 1.25% (95% CI, 0.64 - 2.41), the authors report. The prevalence of suicidal behavior was significantly higher in prospective studies (1.75%; 95% CI, 1.03 - 2.95) than retrospective studies (0.50%; 95% CI, 0.24 to 1.01).
