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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease</title>
<author><name sortKey="Voon, Valerie" sort="Voon, Valerie" uniqKey="Voon V" first="Valerie" last="Voon">Valerie Voon</name>
<affiliation><nlm:aff id="AFF1">National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA,</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name>
<affiliation><nlm:aff id="AFF1">University Joseph Fourier, Grenoble,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dujardin, Kathy" sort="Dujardin, Kathy" uniqKey="Dujardin K" first="Kathy" last="Dujardin">Kathy Dujardin</name>
<affiliation><nlm:aff id="AFF1">Lille University Hospital, Lille,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name>
<affiliation><nlm:aff id="AFF1">National Institute of Health and Medical Research (INSERM), Hôpital de la Pitié-Salpêtrière, Paris,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="D Mbrosia, James" sort="D Mbrosia, James" uniqKey="D Mbrosia J" first="James" last="D Mbrosia">James D Mbrosia</name>
<affiliation><nlm:aff id="AFF1">National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stephane" last="Thobois">Stephane Thobois</name>
<affiliation><nlm:aff id="AFF1">Université Lyon I, Hospital Neurologique Pierre Wertheimer, Lyon, France,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tamma, Filippo" sort="Tamma, Filippo" uniqKey="Tamma F" first="Filippo" last="Tamma">Filippo Tamma</name>
<affiliation><nlm:aff id="AFF1">Neurological clinic, Ospedale San Paolo, Italy,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Herzog, Jan" sort="Herzog, Jan" uniqKey="Herzog J" first="Jan" last="Herzog">Jan Herzog</name>
<affiliation><nlm:aff id="AFF1">Christian-Albrechts-Universität Kiel, Kiel, Germany,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Speelman, Johannes D" sort="Speelman, Johannes D" uniqKey="Speelman J" first="Johannes D." last="Speelman">Johannes D. Speelman</name>
<affiliation><nlm:aff id="AFF1">Academic Medical Center of Amsterdam, Amsterdam, The Netherlands,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Samanta, Johan" sort="Samanta, Johan" uniqKey="Samanta J" first="Johan" last="Samanta">Johan Samanta</name>
<affiliation><nlm:aff wicri:cut=" and" id="AFF1">University of Arizona, Phoenix, AR</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kubu, Cynthia" sort="Kubu, Cynthia" uniqKey="Kubu C" first="Cynthia" last="Kubu">Cynthia Kubu</name>
<affiliation><nlm:aff id="AFF1">The Cleveland Clinic Foundation, OH, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rossignol, Helene" sort="Rossignol, Helene" uniqKey="Rossignol H" first="Helene" last="Rossignol">Helene Rossignol</name>
<affiliation><nlm:aff id="AFF1">University Joseph Fourier, Grenoble,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Saint Cyr, Jean A" sort="Saint Cyr, Jean A" uniqKey="Saint Cyr J" first="Jean A." last="Saint-Cyr">Jean A. Saint-Cyr</name>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ardouin, Claire" sort="Ardouin, Claire" uniqKey="Ardouin C" first="Claire" last="Ardouin">Claire Ardouin</name>
<affiliation><nlm:aff id="AFF1">University Joseph Fourier, Grenoble,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">18941146</idno>
<idno type="pmc">2724899</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724899</idno>
<idno type="RBID">PMC:2724899</idno>
<idno type="doi">10.1093/brain/awn214</idno>
<date when="2008">2008</date>
<idno type="wicri:Area/Pmc/Corpus">000527</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000527</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease</title>
<author><name sortKey="Voon, Valerie" sort="Voon, Valerie" uniqKey="Voon V" first="Valerie" last="Voon">Valerie Voon</name>
<affiliation><nlm:aff id="AFF1">National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA,</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name>
<affiliation><nlm:aff id="AFF1">University Joseph Fourier, Grenoble,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Dujardin, Kathy" sort="Dujardin, Kathy" uniqKey="Dujardin K" first="Kathy" last="Dujardin">Kathy Dujardin</name>
<affiliation><nlm:aff id="AFF1">Lille University Hospital, Lille,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Schupbach, Michael" sort="Schupbach, Michael" uniqKey="Schupbach M" first="Michael" last="Schüpbach">Michael Schüpbach</name>
<affiliation><nlm:aff id="AFF1">National Institute of Health and Medical Research (INSERM), Hôpital de la Pitié-Salpêtrière, Paris,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="D Mbrosia, James" sort="D Mbrosia, James" uniqKey="D Mbrosia J" first="James" last="D Mbrosia">James D Mbrosia</name>
<affiliation><nlm:aff id="AFF1">National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stephane" last="Thobois">Stephane Thobois</name>
<affiliation><nlm:aff id="AFF1">Université Lyon I, Hospital Neurologique Pierre Wertheimer, Lyon, France,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Tamma, Filippo" sort="Tamma, Filippo" uniqKey="Tamma F" first="Filippo" last="Tamma">Filippo Tamma</name>
<affiliation><nlm:aff id="AFF1">Neurological clinic, Ospedale San Paolo, Italy,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Herzog, Jan" sort="Herzog, Jan" uniqKey="Herzog J" first="Jan" last="Herzog">Jan Herzog</name>
<affiliation><nlm:aff id="AFF1">Christian-Albrechts-Universität Kiel, Kiel, Germany,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Speelman, Johannes D" sort="Speelman, Johannes D" uniqKey="Speelman J" first="Johannes D." last="Speelman">Johannes D. Speelman</name>
<affiliation><nlm:aff id="AFF1">Academic Medical Center of Amsterdam, Amsterdam, The Netherlands,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Samanta, Johan" sort="Samanta, Johan" uniqKey="Samanta J" first="Johan" last="Samanta">Johan Samanta</name>
<affiliation><nlm:aff wicri:cut=" and" id="AFF1">University of Arizona, Phoenix, AR</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kubu, Cynthia" sort="Kubu, Cynthia" uniqKey="Kubu C" first="Cynthia" last="Kubu">Cynthia Kubu</name>
<affiliation><nlm:aff id="AFF1">The Cleveland Clinic Foundation, OH, USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rossignol, Helene" sort="Rossignol, Helene" uniqKey="Rossignol H" first="Helene" last="Rossignol">Helene Rossignol</name>
<affiliation><nlm:aff id="AFF1">University Joseph Fourier, Grenoble,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Saint Cyr, Jean A" sort="Saint Cyr, Jean A" uniqKey="Saint Cyr J" first="Jean A." last="Saint-Cyr">Jean A. Saint-Cyr</name>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Ardouin, Claire" sort="Ardouin, Claire" uniqKey="Ardouin C" first="Claire" last="Ardouin">Claire Ardouin</name>
<affiliation><nlm:aff id="AFF1">University Joseph Fourier, Grenoble,</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name>
<affiliation><nlm:aff id="AFF1">University of Toronto, UHN, Toronto, ON, Canada,</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Brain</title>
<idno type="ISSN">0006-8950</idno>
<idno type="eISSN">1460-2156</idno>
<imprint><date when="2008">2008</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>Subthalamic nucleus deep brain stimulation improves motor symptoms and quality of life in advanced Parkinson's disease. As after other life-altering surgeries, suicides have been reported following deep brain stimulation for movement disorders. We sought to determine the suicide rate following subthalamic nucleus deep brain stimulation for Parkinson's disease by conducting an international multicentre retrospective survey of movement disorder and surgical centres. We further sought to determine factors associated with suicide attempts through a nested case-control study. In the survey of suicide rate, 55/75 centres participated. The completed suicide percentage was 0.45% (24/5311) and attempted suicide percentage was 0.90% (48/5311). Observed suicide rates in the first postoperative year (263/100 000/year) (0.26%) were higher than the lowest and the highest expected age-, gender- and country-adjusted World Health Organization suicide rates (Standardized Mortality Ratio for suicide: SMR 12.63–15.64; <italic>P</italic>
<bold><</bold>
0.001) and remained elevated at the fourth postoperative year (38/100 000/year) (0.04%) (SMR 1.81–2.31; <italic>P</italic>
<bold><</bold>
0.05). The excess number of deaths was 13 for the first postoperative year and one for the fourth postoperative year. In the case-control study of associated factors, 10 centres participated. Twenty-seven attempted suicides and nine completed suicides were compared with 70 controls. Postoperative depression (<italic>P</italic>
<bold><</bold>
0.001), being single (<italic>P</italic>
= 0.007) and a previous history of impulse control disorders or compulsive medication use (<italic>P</italic>
= 0.005) were independent associated factors accounting for 51% of the variance for attempted suicide risk. Attempted suicides were also associated (<italic>P</italic>
<bold><</bold>
0.05) with being younger, younger Parkinson's disease onset and a previous suicide attempt. Completed suicides were associated with postoperative depression (<italic>P</italic>
<bold><</bold>
0.001). Postoperative depression remained a significant factor associated with attempted and completed suicides after correction for multiple comparisons using the stringent Bonferroni correction. Mortality in the first year following subthalamic nucleus deep brain stimulation has been reported at 0.4%. Suicide is thus one of the most important potentially preventable risks for mortality following subthalamic nucleus deep brain stimulation for Parkinson's disease. Postoperative depression should be carefully assessed and treated. A multidisciplinary assessment and follow-up is recommended.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Brain</journal-id>
<journal-id journal-id-type="publisher-id">brainj</journal-id>
<journal-id journal-id-type="hwp">brain</journal-id>
<journal-title-group><journal-title>Brain</journal-title>
</journal-title-group>
<issn pub-type="ppub">0006-8950</issn>
<issn pub-type="epub">1460-2156</issn>
<publisher><publisher-name>Oxford University Press</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">18941146</article-id>
<article-id pub-id-type="pmc">2724899</article-id>
<article-id pub-id-type="doi">10.1093/brain/awn214</article-id>
<article-id pub-id-type="publisher-id">awn214</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject>
</subj-group>
</article-categories>
<title-group><article-title>A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Voon</surname>
<given-names>Valerie</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="AFF1"><sup>2</sup>
</xref>
<xref ref-type="author-notes" rid="FN1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Krack</surname>
<given-names>Paul</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lang</surname>
<given-names>Anthony E.</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lozano</surname>
<given-names>Andres M.</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dujardin</surname>
<given-names>Kathy</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schüpbach</surname>
<given-names>Michael</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>D’Ambrosia</surname>
<given-names>James</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Thobois</surname>
<given-names>Stephane</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tamma</surname>
<given-names>Filippo</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Herzog</surname>
<given-names>Jan</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>8</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Speelman</surname>
<given-names>Johannes D.</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>9</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Samanta</surname>
<given-names>Johan</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>10</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kubu</surname>
<given-names>Cynthia</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>11</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rossignol</surname>
<given-names>Helene</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Poon</surname>
<given-names>Yu-Yan</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Saint-Cyr</surname>
<given-names>Jean A.</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ardouin</surname>
<given-names>Claire</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Moro</surname>
<given-names>Elena</given-names>
</name>
<xref ref-type="aff" rid="AFF1"><sup>2</sup>
</xref>
</contrib>
</contrib-group>
<aff id="AFF1"><sup>1</sup>
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA,<sup>2</sup>
University of Toronto, UHN, Toronto, ON, Canada,<sup>3</sup>
University Joseph Fourier, Grenoble,<sup>4</sup>
Lille University Hospital, Lille,<sup>5</sup>
National Institute of Health and Medical Research (INSERM), Hôpital de la Pitié-Salpêtrière, Paris,<sup>6</sup>
Université Lyon I, Hospital Neurologique Pierre Wertheimer, Lyon, France,<sup>7</sup>
Neurological clinic, Ospedale San Paolo, Italy,<sup>8</sup>
Christian-Albrechts-Universität Kiel, Kiel, Germany,<sup>9</sup>
Academic Medical Center of Amsterdam, Amsterdam, The Netherlands,<sup>10</sup>
University of Arizona, Phoenix, AR and<sup>11</sup>
The Cleveland Clinic Foundation, OH, USA</aff>
<author-notes><fn id="FN1"><p>*Present address: National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA</p>
</fn>
<corresp>Correspondence to: Dr Valerie Voon, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, Bldg 10, Rm 5S213, Bethesda, MD 20892-1428, USA E-mail: <email>voonv@ninds.nih.gov</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>10</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="epub"><day>18</day>
<month>10</month>
<year>2008</year>
</pub-date>
<volume>131</volume>
<issue>10</issue>
<fpage>2720</fpage>
<lpage>2728</lpage>
<history><date date-type="received"><day>7</day>
<month>4</month>
<year>2008</year>
</date>
<date date-type="rev-recd"><day>23</day>
<month>6</month>
<year>2008</year>
</date>
<date date-type="accepted"><day>19</day>
<month>7</month>
<year>2008</year>
</date>
</history>
<permissions><copyright-statement>© The Author (2008). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org</copyright-statement>
<copyright-year>2008</copyright-year>
</permissions>
<abstract><p>Subthalamic nucleus deep brain stimulation improves motor symptoms and quality of life in advanced Parkinson's disease. As after other life-altering surgeries, suicides have been reported following deep brain stimulation for movement disorders. We sought to determine the suicide rate following subthalamic nucleus deep brain stimulation for Parkinson's disease by conducting an international multicentre retrospective survey of movement disorder and surgical centres. We further sought to determine factors associated with suicide attempts through a nested case-control study. In the survey of suicide rate, 55/75 centres participated. The completed suicide percentage was 0.45% (24/5311) and attempted suicide percentage was 0.90% (48/5311). Observed suicide rates in the first postoperative year (263/100 000/year) (0.26%) were higher than the lowest and the highest expected age-, gender- and country-adjusted World Health Organization suicide rates (Standardized Mortality Ratio for suicide: SMR 12.63–15.64; <italic>P</italic>
<bold><</bold>
0.001) and remained elevated at the fourth postoperative year (38/100 000/year) (0.04%) (SMR 1.81–2.31; <italic>P</italic>
<bold><</bold>
0.05). The excess number of deaths was 13 for the first postoperative year and one for the fourth postoperative year. In the case-control study of associated factors, 10 centres participated. Twenty-seven attempted suicides and nine completed suicides were compared with 70 controls. Postoperative depression (<italic>P</italic>
<bold><</bold>
0.001), being single (<italic>P</italic>
= 0.007) and a previous history of impulse control disorders or compulsive medication use (<italic>P</italic>
= 0.005) were independent associated factors accounting for 51% of the variance for attempted suicide risk. Attempted suicides were also associated (<italic>P</italic>
<bold><</bold>
0.05) with being younger, younger Parkinson's disease onset and a previous suicide attempt. Completed suicides were associated with postoperative depression (<italic>P</italic>
<bold><</bold>
0.001). Postoperative depression remained a significant factor associated with attempted and completed suicides after correction for multiple comparisons using the stringent Bonferroni correction. Mortality in the first year following subthalamic nucleus deep brain stimulation has been reported at 0.4%. Suicide is thus one of the most important potentially preventable risks for mortality following subthalamic nucleus deep brain stimulation for Parkinson's disease. Postoperative depression should be carefully assessed and treated. A multidisciplinary assessment and follow-up is recommended.</p>
</abstract>
<kwd-group><kwd>suicide</kwd>
<kwd>deep brain stimulation</kwd>
<kwd>Parkinson's disease</kwd>
<kwd>depression</kwd>
<kwd>subthalamic stimulation</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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