Data from: Risk factors for suicidality in Huntington's disease: an analysis of the 2CARE clinical trial

Most suicidality literature in HD is based on natural history studies or
retrospective reviews, but reports on risk factors from clinical trials
are limited. We 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. We also considered time from
randomization until the first suicide attempt as a secondary outcome
variable. 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, tetrabenazine use, and treatment assignment (coenzyme
Q10 or placebo) were not associated with suicidality. Time-dependent
variables from the UHDRS 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. Variables associated with time to suicide
attempt alone were generally similar. These data suggest psychiatric
co-morbidities in 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. Designing a composite algorithm for early prediction of
suicide attempts in HD may be of value, particularly given anticipated
trials aimed at disease modification are likely to be long-term.