Parkinson’s Disease and Suicide: A Review

Review Article

Parkinson’s Disease and Suicide: A Review

Arja Mainio
Affiliation: Oulu University Hospital, Department of Psychiatry, Oulu, Finland


ABSTRACT

Psychiatric disorders are very often present in patients with Parkinson’s disease (PD), with affective disorders being the most common. Depression in PD is atypical compared with depression in non‐PD patients. Psychosis and impulsive control disorders have been found to be present in advanced disease. Although suicidal thoughts are often present among PD patients, the prevalence of completed suicide is less frequent than that in the general population. The reason for the lower prevalence of suicide has not been resolved. However, recent studies have highlighted an elevated risk for suicide among PD patients with deep brain stimulation (DBS). The following risk factors for suicidality after DBS have been described: young age; males with chronic course of disease with pre/postoperative depression; other psychiatric conditions such as apathy, psychotic disorders, substance use, impulsive control disorders, or having earlier suicide attempts. The mechanism behind the suicidal behavior among PD patients with DBS is also obscure. In prevention of suicide, it is important that comorbid psychiatric disorders are diagnosed and treated in accordance with the principles of general treatment of choice.

Keywords: Parkinson disease, depression, impulsive-compulsive disorders, suicidal ideation, suicide, depression, deep brain stimulation
Correspondence: A Mainio, Oulu University Hospital, Department of Psychiatry, PO Box 26 90029 OYS, Oulu, Finland. Tel: +(358)-8-3156706; Fax: +(358)-8-3154648