Cognitive Neuroscience Laboratory, Think+Speak lab, Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL 60611, USA.
Cognitive Neuroscience Laboratory, Think+Speak lab, Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL 60611, USA.
J Affect Disord. 2019 May 1;250:319-329. doi: 10.1016/j.jad.2019.03.043. Epub 2019 Mar 5.
An increased risk of suicide in Huntington's disease (HD) patients is well documented, with rates significantly higher than those of the general population as well as other neurodegenerative diseases. However, despite its prevalence, the magnitude of this phenomenon as well as its predictors and etiology are still poorly understood.
We performed the first systematic review of all the studies published between March 1993 and December 2018 which investigated HD patients and gene carriers that reported suicidal ideation, suicide attempt, or suicide as an outcome.
This review reveals that some aspects of suicidality in HD are more clearly understood than others. We confirm an increased risk of suicidal ideation, suicide attempt, and suicide for HD patients. We found that suicidal ideation is elevated throughout the course of the disease, and that psychiatric comorbidities are common risk factors with depression being the most prominent.
Important data are still largely missing, specifically regarding cognitive and neuroanatomical mechanisms and potential effective interventions. Moreover, inconsistencies in terminology, assessment tools, and outcome measures limit the comparability of the research and the conclusions that can be drawn.
Incidence of suicidal ideation, suicide attempt, and suicide are higher among those with HD relative to the non-HD population. It is therefore important that suicidal thoughts and behaviors are closely monitored in HD clinics and that clinical trials use standardized scales. Future research should focus on better understanding the etiology of this high suicide risk and on testing the efficacy of potential interventions.
亨廷顿病（HD）患者的自杀风险增加已得到充分证实，其发生率明显高于普通人群和其他神经退行性疾病。然而，尽管这种现象很普遍，但人们对其程度及其预测因素和病因仍知之甚少。
我们对 1993 年 3 月至 2018 年 12 月期间发表的所有研究进行了首次系统综述，这些研究调查了报告自杀意念、自杀未遂或自杀作为结局的 HD 患者和基因携带者。
本综述表明，HD 患者自杀行为的某些方面比其他方面更容易理解。我们确认 HD 患者自杀意念、自杀未遂和自杀的风险增加。我们发现自杀意念在整个疾病过程中都升高，精神共病是常见的危险因素，其中抑郁症最为突出。
重要的数据仍然很大程度上缺失，特别是关于认知和神经解剖学机制以及潜在的有效干预措施。此外，术语、评估工具和结果测量的不一致限制了研究的可比性和可以得出的结论。
与非 HD 人群相比，HD 患者自杀意念、自杀未遂和自杀的发生率更高。因此，在 HD 诊所中密切监测自杀念头和行为非常重要，并且临床试验应使用标准化量表。未来的研究应侧重于更好地理解这种高自杀风险的病因，并测试潜在干预措施的疗效。
