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Abstract
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Depression is the most common condition associated with suicide among elderly individuals.[1] As patients with Parkinson's disease (PD) have many risk factors for suicide,[1] we enjoyed reading the recent article entitled, "Psychiatric morbidity in patients with idiopathic Parkinson's disease: A cross-sectional study" by Kumar et al. published in your esteemed journal.[2] Elegantly, the authors observed that patients with PD have a high prevalence of psychiatric morbidity (mainly depressive disorders) and a significant number of these individuals had suicidality.[2] Following these important clinical findings, we would like to add some thoughts that may open the debate about the possible role of lipids as biological markers of suicide in PD patients.
PD is one of the most frequent age-related neurodegenerative disorders and affects millions of people globally, there is no cure, and several data over the years have shown that PD is not a benign condition since it has a high rate of premature death compared with the general population.[3] The main causes of death for PD patients are pneumonia and cerebrovascular and cardiovascular diseases.[3] In parallel, it is very pertinent to point out that one of the events related to this excess mortality but infrequently mentioned is suicide.[1] Really, although there are clear indications that the number of suicides is highest among older adults in almost all regions of the world, this remains an area in need of study in PD.[1] Looking through this prism, findings from several studies have shown that suicidal ideation is common in PD.[1],[2] Importantly, although there is little consensus on the association between suicide and PD, several studies have demonstrated high suicide rates in PD patients.[1],[4] Obviously, patients with PD have many risk factors for suicide.[1],[2] However, as approximately 40%-50% of patients with PD are affected by depression,[4] the risk of death by suicide in PD may, in part, be related to the severity of the depression.[1],[4] With these considerations in mind, we are also convinced that future studies should explore factors to better understand the high suicide risk in PD.[4] In these terms, many researchers have attempted to identify biological markers that could be linked to suicidal behavior.[1] These studies suggest that lipid changes may be related to suicidality.[5] One possible explanation is that low cholesterol levels result in decreased brain serotonin availability, the neurochemical system that suppresses aggressive or socially inappropriate behaviors.[5] Another explanation could be that decreased blood levels of cholesterol are correlated with symptoms of depression, a significant suicide risk factor...
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