Risk Factors for Suicidal Ideation in People at Risk for Huntington’s Disease

Article type: Research Article

Authors: Anderson, Karen E.^{a; b; *} | Eberly, Shirley^c | Groves, Mark^{d; e} | Kayson, Elise^f | Marder, Karen^g | Young, Anne B.^h | Shoulson, Ira^b | PHAROS Investigators

Affiliations: [a] Department of Psychiatry, Research Division, Georgetown University, Washington, DC, USA | [b] Department of Neurology, Georgetown University, Washington, DC, USA | [c] Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA | [d] Department of Psychiatry, Icahn School of Medicine at Mt. Sinai, New York, NY, USA | [e] Department of Neurology, Icahn School of Medicine at Mt. Sinai, New York, NY, USA | [f] Center for Human Experimental Therapeutics/Clinical Trials Coordination Center, University of Rochester, Rochester, NY, USA | [g] Department of Neurology, Psychiatry, and Taub Institute for Alzheimer’s Disease and The Aging Brain, Columbia University Medical Center, New York, NY, USA | [h] Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

Correspondence: [*] Correspondence to: Karen E. Anderson, MD, Georgetown University, Washington, DC, USA. Tel.: +1 202 687 4870; E-mail: kea45@georgetown.edu.

Abstract: Background: Suicidal ideation (SI) and attempts are increased in Huntington’s disease (HD), making risk factor assessment a priority. Objective: To determine whether, hopelessness, irritability, aggression, anxiety, CAG expansion status, depression, and motor signs/symptoms were associated with Suicidal Ideation (SI) in those at risk for HD. Methods: Behavioral and neurological data were collected from subjects in an observational study. Subject characteristics were calculated by CAG status and SI. Logistic regression models were adjusted for demographics. Separate logistic regressions were used to compare SI and non-SI subjects. A combined logistic regression model, including 4 pre-specified predictors, (hopelessness, irritability, aggression, anxiety) was used to assess the relationship of SI to these predictors. Results: 801 subjects were assessed, 40 were classified as having SI, 6.3% of CAG mutation expansion carriers had SI, compared with 4.3% of non- CAG mutation expansion carriers (p = 0.2275). SI subjects had significantly increased depression (p < 0.0001), hopelessness (p < 0.0001), irritability (p < 0.0001), aggression (p = 0.0089), and anxiety (p < 0.0001), and an elevated motor score (p = 0.0098). Impulsivity, assessed in a subgroup of subjects, was also associated with SI (p = 0.0267). Hopelessness and anxiety remained significant in combined model (p < 0.001; p < 0.0198, respectively) even when motor score was included. Conclusions: Behavioral symptoms were significantly higher in those reporting SI. Hopelessness and anxiety showed a particularly strong association with SI. Risk identification could assist in assessment of suicidality in this group.

Keywords: Huntington’s disease, suicidal ideation, suicide, suicide attempt

DOI: 10.3233/JHD-160206

Journal: Journal of Huntington's Disease, vol. 5, no. 4, pp. 389-394, 2016