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J Huntingtons Dis. 2018;7(3):239-249. doi: 10.3233/JHD-180299.

Suicidal Ideation Assessment in Individuals with Premanifest and Manifest Huntington Disease.

Author information

1
Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN, USA.
2
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
3
Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.
4
Radiology, Neuroscience, Physical Therapy, Occupational Therapy, Washington University in St. Louis, St. Louis, MO, USA.
5
Neurology, Psychiatry, Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA.
6
Department of Pathology, Rowan University School of Medicine, Glassboro, NJ, USA.
7
Department of Psychiatry, Rutgers-RWJMS, Piscataway Township, NJ, USA.

Abstract

BACKGROUND:

Huntington disease (HD) is associated with increased risk of suicide.

OBJECTIVE:

This study compares suicide ideation in HD to the general population, assesses factors associated with increased prevalence of suicidal thoughts, and compares clinician-rated to self-reported assessments of suicidal ideation.

METHODS:

We examined 496 participants with premanifest or manifest HD. Clinician-rated suicidal ideation was measured using the Problem Behaviors Assessment - short form. Self-reported ideation was measured using two items from the HDQLIFE Concern with Death and Dying item bank. Independent sample t-tests were conducted to compare the prevalence of suicidal thoughts between our HD sample and the U.S.

POPULATION:

Logistic regression analyses were used to determine characteristics associated with higher odds of clinically significant suicidal ideation. Kappa agreement coefficients were calculated to evaluate concurrence between clinician-rated and self-reported assessments.

RESULTS:

Our sample had a significantly higher occurrence of suicidal ideation (19.76%) and suicidal plans (2.1%) than the general population (p < 0.0001). Odds of clinically significant suicidal ideation were 6.8 times higher in females (p = 0.04) on the clinician measure, and Hispanic/Latinos had 10.9 times higher odds than non-Hispanics (p = 0.025) on the self-report measure. Clinician-rated assessment had fair agreement (k = 0.2-0.4) with self-reported assessments, except in early stage HD where there was no overlap in the identification of participants with clinically significant suicidal ideation.

DISCUSSION:

Assessment for suicidal ideation and clinically significant suicidal thoughts in HD with a multimodal approach that includes clinician-rated and self-report measures is critical at all stages of the disease.

KEYWORDS:

Huntington disease; comparing methods; suicidal ideation; suicide; suicide assessment

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