Background. Previous studies investigated the risk of suicide in patients with Parkinson’s disease (PD) but reported discrepant results. Deep brain stimulation (DBS) is an effective therapy for PD, while its effect on suicide risk has seldom been researched. This meta-analysis aimed to estimate the risk of suicide and/or suicidal ideation in PD patients and in PD patients who underwent DBS. Methods. Relevant articles published in the PubMed or EMBASE or CNKI database from 1990 to December 2019 were sourced, and the combined standardized mortality rate (SMR) or odds ratio (OR) was pooled. Result. A total of 1070 articles were found. After screening, 4 cross-sectional studies, 4 cohort studies, 2 randomized controlled trial studies, and 2 case-control studies were included in this meta-analysis. Pooled data indicated that PD patients may have increased risk of suicide (lnSMR, 0.459; 95% confidence interval (CI), 0.286 to 0.632; ). No significant difference was found in the risk of suicide when comparing PD patients who underwent DBS with PD patients who received only drug therapy (OR = 2.844, 95%CI: 0.619 to 13.072, ). DBS may increase the risk of suicide and/or suicidal ideation in PD patients compared with general population (lnSMR = 3.383, 95%CI: 2.839 to 3.927, ). Conclusion. PD patients have higher risk of suicide and/or suicidal ideation compared with controls, while PD patients who received DBS tend to have an increased risk of suicide or suicidal ideation. Psychological evaluation is needed in PD patients, and pre- and post-operation evaluations are necessary for PD patients who underwent DBS.

中文翻译：

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帕金森病相关的自杀风险和深部脑刺激的影响：荟萃分析

背景。先前的研究调查了帕金森病 (PD) 患者的自杀风险，但报告的结果存在差异。深部脑刺激 (DBS) 是治疗 PD 的有效疗法，但其对自杀风险的影响却鲜有研究。这项荟萃分析旨在评估 PD 患者和接受 DBS 的 PD 患者的自杀和/或自杀意念的风险。方法。检索 1990 年至 2019 年 12 月在 PubMed 或 EMBASE 或 CNKI 数据库中发表的相关文章，并汇总标准死亡率（SMR）或优势比（OR）。结果. 共找到 1070 篇文章。经过筛选，4项横断面研究、4项队列研究、2项随机对照试验研究和2项病例对照研究被纳入本荟萃分析。汇总数据表明，PD 患者的自杀风险可能增加（lnSMR，0.459；95% 置信区间 (CI)，0.286 至 0.632；）。将接受 DBS 的 PD 患者与仅接受药物治疗的 PD 患者进行比较时，自杀风险没有显着差异（OR = 2.844，95%CI：0.619 至 13.072，）。与一般人群相比，DBS 可能增加 PD 患者自杀和/或自杀意念的风险（lnSMR = 3.383, 95%CI: 2.839 to 3.927,）。 结论。与对照组相比，PD 患者自杀和/或自杀意念的风险更高，而接受 DBS 的 PD 患者自杀或自杀意念的风险往往更高。PD患者需要进行心理评估，对于行DBS的PD患者需要进行术前术后评估。