Perseveration and Suicide in Huntington's Disease.

BACKGROUND

Huntington's disease (HD) patients are at significantly higher risk of suicidal behavior, and associated cognitive and behavioral factors play an important role. Impulsivity is commonly thought to be a risk factor, but does not completely account for all suicide attempts.

OBJECTIVE

To provide clinical evidence that perseverative behavior may precipitate suicide attempts in HD.

METHODS

Case review of four HD patients who attempted suicide.

RESULTS

Each patient demonstrated a clinical history of perseverative behavior, and endorsed perseveration on upsetting thoughts leading up to their suicide attempts. The attempts were planned in response to these ruminations.

CONCLUSIONS

The patients in this series experienced uncontrollable distressful thoughts prior to their thoughtfully planned suicide attempts. These patients did not appear to act impulsively in their decision to attempt suicide.