Suicidality among patients with X-linked Dystonia-Parkinsonism (XDP)

Roland Dominic G. Jamora, Alvin Rae F. Cenina, Rosalia A. Teleg and Lillian V. Lee

Background.  Sex-linked dystonia-parkinsonism (XDP) is an adult-onset, progressive, debilitating movement disorder that manifests with features of dystonia and parkinsonism. It is endemic among Filipino males from Panay Island. Many of these patients would have peculiar postures and bizarre movements forcing them to retreat to the confines of their home or probably in solitude.

Objective. To describe the rate of suicide among XDP patients.

Methods. We identified the patients from the Philippine XDP registry maintained by the XDP Study Group. A retrospective chart review was then done.

Results. There were 21 deaths attributable to suicide from the 194 deaths from the XDP registry (10.8%). The mean age at suicide was 44 + 11.38 years, around 7.76 + 4.65 years from onset of illness and  5.81 + 4.32 years from the diagnosis. Most patients (17/21) were in the generalized dystonia stage at the time of suicide. Five of the suicide cases belonged to two families. The most common method of suicide were hanging (10, 47.6%), refusal to eat (5, 23.8%), non-accidental organophosphate poisoning and self-mutilation (1 each, 4.8%).

Conclusion. There was a high rate of suicide (10.8%) among XDP patients compared to the national suicide rate of 3.59/100,000. Hanging was the most common method used to commit suicide.

Key Words: DYT3, suicide, XDP