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Original Paper

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Suicidal Behavior in Prodromal Huntington Disease

Fiedorowicz J.G.a, b · Mills J.A.a · Ruggle A.a · Langbehn D.a · Paulsen J.S.a, c, d · PREDICT-HD Investigators of the Huntington Study Group

Author affiliations

Departments of aPsychiatry, Carver College of Medicine, bEpidemiology, College of Public Health, cNeurology, Carver College of Medicine, and dPsychology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, Iowa, USA

Corresponding Author

Jane S. Paulsen, PhD

Department of Psychiatry, University of Iowa

500 Newton Rd., 1-305 MEB

Iowa City, IA 52242 (USA)

Tel. +1 319 353 4551, E-Mail jane-paulsen@uiowa.edu

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Neurodegenerative Dis 2011;8:483–490

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Background: Several studies have suggested a greater risk of suicide in Huntington disease (HD); however, unique risk factors for suicide in HD are not established. Objective: We sought to determine risk factors for suicidal behavior, defined as suicide or attempted suicide, in prodromal HD. Methods: From the prospective PREDICT-HD cohort, we identified 735 cases with HD gene expansion but no manifest symptoms of HD and 194 non-gene-expanded controls. In survival analysis, a number of potential risk factors for suicidal behavior were assessed, including symptoms of depression, hopelessness, substance abuse, marital status, gender, and psychiatric history. Results: During a mean of 3.7 years of prospective follow-up, 12 cases (1.6%) attempted suicide and 1 completed suicide (0.1%). No suicides were observed among controls. In univariate Cox proportional hazards regression models, a history of suicide attempts (HR 8.5, 95% CI 2.8–26.1, p < 0.0002) and a Beck Depression Inventory II score >13 (HR 7.2, 95% CI 2.3–22.0, p < 0.0006) were associated with suicidal behavior. These risk factors had independent effects in multivariate models. A history of incarceration in the past 2 years was also associated (HR 12.5, 95% CI 2.7–56.6, p < 0.002), though uncommon. No further risk factors were identified. Conclusion: A history of suicide attempts and the presence of depression are strongly predictive of suicidal behavior in prodromal HD. As these risk factors are among the most robust risk factors for suicide, established suicide risk factors appear applicable to those with prodromal HD.

© 2011 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: August 18, 2010
Accepted: March 14, 2011
Published online: June 09, 2011
Issue release date: August 2011

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 4

ISSN: 1660-2854 (Print)
eISSN: 1660-2862 (Online)

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