Identifying Predictors of Suicidal Behavior in Huntington Disease

Psychiatry Advisor Contributing Writer
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Brain in Huntington’s disease. FLAIR magnetic resonance imaging (MRI) scan of a coronal section through the brain of a 21-old patient with Huntington’s disease, showing atrophy (wasting) of the cortex and caudate nuclei. Huntington’s disease is a neurodegenerative genetic disorder that affects muscle coordination and leads to mental decline and behavioral symptoms.
Researchers sought to identify variables that were associated with suicidal ideation or behavior in patients with Huntington disease.

Psychiatric comorbidities are predictors of suicidal behavior in patients with Huntington disease, according to a study published in Neurology.

Researchers analyzed data from the 2CARE (Coenzyme Q10 in Huntington’s Disease, ClinicalTrials.gov identifier NCT00608881) randomized, double-blind clinical trial for variables associated with suicidal ideation or behavior in patients with Huntington disease. The 2CARE trial included patients diagnosed with Huntington disease who were randomly assigned to receive either a coenzyme Q10 dose of 2400 mg/day or a corresponding placebo.

Data were collected at baseline, months 1, 3, and 6, then every 6 months until an end date of 5 years. Suicidal ideation and attempts were gathered either from adverse events reports or answers to specific questions on the Unified Huntington’s Disease Rating Scale Behavioral Assessment.

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Of the 609 patients included in this study, the median follow-up time frame was 50.6 months; 9% of participants reported experiencing at least 1 instance of suicidal ideation or suicide attempt over the course of the study. Of the patients who experienced suicidal ideation or attempts, 88.5% had an active psychiatric diagnosis, 80.8% used psychiatric medication, and 28.8% had suicidal ideation before the start of the study. Active depression (P =.0003), anxiety (P =.003), bipolar disorder (P =.01), and a history of suicidal ideation (P =.0004) were found to be baseline variables associated with time to suicidal ideation or attempt.

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The primary limitation of this study involves the selection bias for patients enrolling in clinical trials. Most of these patients were moderately functional with personal support and caregiver involvement.

The researchers concluded “psychiatric comorbidities in [Huntington disease] are predictive of suicidal behavior” and it is valuable to understand “how clinical trial participation affects the behavioral health of participants.”

Disclosures: Drs McGarry and Cudkowics report multiple associations with pharmaceutical companies. Please refer to the original reference for a full list of authors’ disclosures.

Reference

McGarry A, McDermott MP, Kieburtz K, et al; the Huntington Study Group 2CARE Investigators and Coordinators. Risk factors for suicidality in Huntington disease: an analysis of the 2CARE clinical trial [published online March 8, 2019]. Neurology. doi: 10.1212/WNL.0000000000007244

This article originally appeared on Neurology Advisor