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Sleep Med. 2018 Oct 11;54:1-7. doi: 10.1016/j.sleep.2018.09.019. [Epub ahead of print]

Suicidal thought and behavior in individuals with restless legs syndrome.

Author information

1
Department of Neurology, Yale University, New Haven, CT, USA.
2
Department of Neurology, Yale University, New Haven, CT, USA; Center for Neuroepidemiology and Clinical Neurologic Research, Yale, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA.
3
Department of Neurology, Yale University, New Haven, CT, USA; Center for Neuroepidemiology and Clinical Neurologic Research, Yale, New Haven, CT, USA. Electronic address: brian.koo@yale.edu.

Abstract

BACKGROUND:

Restless legs syndrome (RLS) is associated with an unrelenting urge to move at night, which can cause chronic sleeplessness, depression, and despondency; thus increasing risk of suicide. We aimed to determine frequency of suicidal ideation and behavior in RLS.

METHODS:

RLS and control participants were recruited through community and RLS Foundation advertisements. RLS diagnosis was confirmed using the Cambridge-Hopkins RLS Questionnaire and severity was assessed using the International RLS Study Group Severity Scale (IRLSS). Lifetime suicidal ideation (plan) and behavior (attempt) was assessed using the Suicidal Behavior Questionnaire-revised. The Brief Lifetime Depression Scale evaluated lifetime depression history. Forward stepwise logistic regression determined the odds of suicidal ideation or behavior.

RESULTS:

In this study, 192 RLS and 158 control participants were comparable for age, sex, race, and other potential demographic confounders. In general, RLS was moderate-to-severe (mean IRLSS 26.4 ± 7.5). Significantly more RLS than control participants had lifetime suicidal ideation or behavior (27.1% vs. 7.0%; p < 0.00001) or lifetime depression history (65.6%% vs. 22.8%; p < 0.00001). The odds of having a lifetime suicidal ideation or behavior was higher in those with RLS [2.80 (1.29,6.11)], even after accounting for depression and other confounders. In RLS, the odds of lifetime suicidal ideation or behavior was increased if there was lifetime depression [7.37 (2.65,20.47)] or if RLS in the past was severe or very severe [2.36 (1.03,5.40)].

CONCLUSIONS:

Lifetime suicidal ideation or behavior is prevalent in RLS sufferers, and its likelihood is dependent on RLS severity and depression history.

KEYWORDS:

Depression; Restless legs syndrome; Suicide

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