Objective: To assess the frequency of, and predictors of, suicidal ideation (SI) in people with parkinsonism (PwP).

Background: Both the neuropsychiatric and motor features, coupled with the incurable progression of parkinsonism, make people with the condition at risk of dying by suicide. A meta-analysis found a pooled prevalence of SI of 22%. Higher severity of motor and non-motor symptoms, younger age, and perceived disability have been associated with increased SI, but study populations are not always representative of clinical populations. Using data from the PRIME-UK Cross Sectional study, designed to be inclusive and representative, we analysed the prevalence of SI and associated factors.

Method: This single-centre cross-sectional study included participants with a diagnosis of idiopathic Parkinson’s Disease (PD), and other types of parkinsonism (excluding drug-induced). Data was collected via a self-completed questionnaire booklet, with additional support provided where required. A participant was deemed to have SI if they responded to the suicidality item of the Beck Depression Inventory (BDI-II) to indicate they had either suicidal thoughts or intent.  We present descriptive statistics and univariable and multivariable logistic regression models to estimate associations between PD symptoms, health and demographic measures, and SI.

Results: 439 participants answered the suicidality item (66% male, mean age 75.4 years +/- 8.5) with 19% (n=82, 95% CI 15-22%) reporting SI. Factors associated with SI in univariable logistic regression were female sex (OR 1.89, 95%CI 1.16-3.08, p=0.01), increased non-motor symptoms (NMS) (OR 1.15, 95%CI 1.09-1.21, p<0.001), autonomic symptom burden (OR 1.06, 95%CI 1.03-1.1, p<0.001),  increased functional impairment/disability (OR 1.02, 95%CI 1.01-1.03, p<0.001), and living in rented accommodation as compared to own home (OR 4.94, 95%CI 2.51-9.74, p<0.001). In the multivariable model, non-motor symptom burden (OR 1.1, 95%CI 1.03-1.19, p=0.005) and rented accommodation (OR 2.95, 95%CI 1.15- 7.53, p=0.02) predicted SI.

Conclusion: We demonstrated that SI is prevalent in this population. Higher NMS and rented accommodation predicted SI. It is important to be aware of this risk in clinical practice and our data support clinicians to identify those at greater risk. Further research should determine appropriate and effective screening and interventions to prevent harm.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/predictors-of-suicidal-ideation-amongst-people-with-parkinsonism-in-the-prime-uk-cross-sectional-study/