Journal Article Annotations
2020, 4th Quarter


Annotations by Liliya Gershengoren, MD
December, 2020

  1. Risk of Suicide Among Patients With Parkinson Disease

PUBLICATION #1 — Suicide

Risk of Suicide Among Patients With Parkinson Disease
Ying-Yeh Chen, Sun Yu, Ya-Hui Hu, Chung-Yi Li, Fanny Artaud, Laure Carcaillon-Bentata, Alexis Elbaz, Pei-Chen Lee


The finding:
Based on the data from Taiwan’s National Health Insurance data set and Taiwan Death Registry, this population-based cohort study demonstrated that patients with Parkinson Disease have a suicide risk that is 2 times as high as the general population after adjustment for medical comorbidities, dementia and mental disorders. Patients with Parkinson Disease were likely to be younger, have a diagnosis of mental disorder, live in urban area and employ jumping as their method of suicide when compared to the control group participants. Risk factors for suicide were low to moderate disease severity and the presence of mental illness including depression.

Strength and weaknesses:
This cohort study includes a large representative sample with a long follow-up. Over the course of 11 years, there were 35 891 patients with PD matched to 143 557 control participants. This is a study based on data recorded in Taiwan and so may not be generalizable. The authors themselves recognize that there may be an underdiagnosis of mental illness due to mental illness stigma in Chinese societies. Furthermore, the data sets did not include relevant factors such as lifestyle behaviours, ethnicity, or disease history or staging.

Parkinson Disease is associated with motor symptoms as well as depression and anxiety over the course of the illness, which consult psychiatrists are often asked to address. Furthermore, there is a recognized association between physical disability and suicide risk in younger and middle-aged patients. This description of risk factors can help consult psychiatrists identify those patients with Parkinson Disease who are at a higher risk for suicide. That the authors describe mental health stigma resulting in underdiagnosis of depression among Chinese societies highlights the importance of cultural competence for consult psychiatrists.

Type of study: (EBM guide):
Cohort study