Journal of Neurology (2018) 265:1303–1309
Neurological diseases and risk of suicide attempt: a case–control study
· Kim Peder Dalho
· Henrik Horwitz
Received: 22 January 2018 / Revised: 5 March 2018 / Accepted: 16 March 2018 / Published online: 21 March 2018
© Springer-Verlag GmbH Germany, part of Springer Nature 2018
Introduction Neurological diseases have a profound impact on quality of life. We investigated the risk of suicide attempt in
ten neurological diseases.
Methods Case–control study. Cases were identiﬁed from the Danish Poison Information Centre database in the period
2006–2013. The prevalence of ten neurological diagnoses was compared with the prevalence in a randomly sampled age-
and gender-matched control group.
Results We identiﬁed 8974 cases of suicidal attempt and 89,740 controls. We found an association between suicide attempt
in nine of ten neurological diseases and disease groups, including stroke [odds ratio (OR) 3.1, 95% conﬁdence interval (CI)
(2.8–3.6)], Huntington’s disease [OR 8.8, 95% CI (3.2–24.1)], amyotrophic lateral sclerosis [OR 5.0, 95% CI (1.7–14.6)],
Parkinson’s disease [OR 2.9, 95% CI (1.8–4.6)], Alzheimer’s disease and other degenerative diseases [OR 4.8, 95% CI
(3.1–7.5)], multiple sclerosis [OR 1.5, 95% CI (1.1–2.1)], epilepsy [OR 4.5, 95% CI (4.1–5.0)], hereditary and idiopathic
neuropathy [OR 2.2, 95% CI (1.1–4.3)] and myasthenia gravis [OR 4.3, 95% CI (2.0–9.4)].
Conclusion Nine out of ten chronic neurological diseases were associated with an increased risk of suicide attempt. These
data must be considered for clinicians treating this vulnerable group of patients.
Keywords Suicide attempt · Self-poisoning · Neurological diseases · Neuropsychiatry
Suicidal behavior is an important consideration in patients
with neurological diseases, as it can be a desperate last resort
to escape from the burdensome chronic symptoms. Com-
pared to the management of physical symptoms, there is less
attention on the psychological consequences of living with a
neurological disease, and the psychiatric comorbidities are
often unrecognized and untreated .
Previous research has found an increased risk of suicide
in patients with certain neurological diseases, including
epilepsy, stroke, multiple sclerosis (MS), Huntington’s dis-
ease, amyotrophic lateral sclerosis (ALS) and Parkinson’s
disease [2–8], whereas suicide attempts in patients with neu-
rological diseases are less well-studied. Deliberate self-poi-
soning is the most common method of suicide attempt ,
but whether there is a positive association with individual
neurological diseases has yet to be investigated.
We did a large case–control study of the association
between individual neurological diseases and suicide attempt
The Danish National Patient Register (DNPR) contains
information on all somatic in- and out-patients in Dan-
ish hospitals, whereas the Danish Psychiatric Central
Research Register (PCRR) register hold data of patients
treated at psychiatric departments in Denmark . For
each patient contact, one primary and optional secondary
* Henrik Horwitz
Kim Peder Dalhoﬀ
Department of Clinical Pharmacology, Bispebjerg
and Frederiksberg Hospital, University of Copenhagen,
Bispebjerg Bakke 23, 2400 Copenhagen, NV, Denmark