Recent findings suggest psychiatric comorbidities in Huntington disease (HD) are predictive of suicidal behavior while participating in clinical trials, reinforcing the importance of clinical surveillance and treatment towards lessening risk during participation and perhaps beyond. Researchers analyzed 609 participants from 2CARE, a randomized, double-blind, placebo-controlled clinical trial with up to 5 years of follow-up, for risk factors related to suicidality. The primary outcome variable was the time from randomization until the first occurrence of either suicidal ideation or attempt. They also considered time from randomization until the first suicide attempt as a secondary outcome variable. They found:
- Depression, anxiety, bipolar disorder, antidepressant or anxiolytic use, and prior suicide attempt at baseline were associated with time to ideation or attempt.
- Baseline employment status, marital status, CAG repeat length, and treatment assignment (coenzyme Q10 or placebo) were not associated with suicidality.
- Time-dependent variables from the Unified Huntington's Disease Rating Scale Behavioral Assessment were associated with time to suicidal ideation or attempt, driven mainly by items related to depressed mood, low self-esteem/guilt, anxiety, suicidal thoughts, irritability, and compulsions.
McGarry A, McDermott MP, Kieburtz K, et al. Risk factors for suicidality in Huntington disease. An analysis of the 2CARE clinical trial for the Huntington Study Group 2CARE Investigators and Coordinators. [Published online ahead of print March 8, 2019]. Neurology. doi:10.1212/WNL.0000000000007244.
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