Objective: To identify racial and ethnic differences in history of suicidal ideation among Huntington’s Disease patients, using the ENROLL-HD, 2020 periodic dataset.

Background: Suicidal ideation (SI) and suicidality are leading causes of morbidity and mortality among Huntington’s Disease (HD) patients. Although HD is frequently described in White Non-Hispanic communities, many HD centers in the US care for many racial and ethnic minoritized groups.

Method: In this cross-sectional study, we evaluated the odds of reporting a history of suicidal ideation (yes/no) across different racial and ethnic groups during baseline ENROLL-HD visit. We used multivariate logistic regression models adjusting for sex, age, total functional capacity score (TFC), history of cognitive impairment, employment status, educational attainment, and participant’s residential location.

Results: This analysis identified 4717 genetically confirmed HD participants (36+ CAG repeats) in North America. 56% of participants were female, and only 10% (n=494) of participants identified as a race or ethnicity other than White. 3.4% identified as Latino, 2.3% as Black, 1.1% as Native American, and 0.7% as Asian. Female participants had higher odds of reporting SI (OR 1.15, CI 1.00-1.30). There was a higher proportion of Native American participants who reported a history of SI (47.2%). Those who listed “Other” as their race/ethnicity were more likely to deny a history of SI (93.0%). Native American participants had higher odds of a history of SI (OR 2.36, CI 1.37-4.06). Similar differences were noted when adjusting for biological variables (AOR 2.27, CI 1.3- 3.96) and sociodemographic variables (AOR 2.17, CI 1.22-3.84). Factors associated with lower odds of a SI included race listed as “Other” (AOR 0.20, CI 0.06-0.66), being employed during baseline visit (AOR 0.75, CI 0.63-0.89), and completing higher education (AOR 0.86, CI 0.74-0.99).

Conclusion: Our findings suggest Native American individuals with HD are more likely to experience SI than other racial groups. Qualitative studies with Native American patients with HD are needed to better understand specific risk factors of SI in this patient population and identify culturally appropriate interventions to manage these psychiatric symptoms in this group.

References: 1. Kachian ZR, Cohen-Zimerman S, Bega D, Gordon B, Grafman J. Suicidal ideation and behavior in Huntington’s disease: Systematic review and recommendations. J Affect Disord. 2019;250:319-329. doi:10.1016/J.JAD.2019.03.043
2. Honrath P, Dogan I, Wudarczyk O, et al. Risk factors of suicidal ideation in Huntington’s disease: literature review and data from Enroll-HD. J Neurol. 2018;265(11):2548-2561. doi:10.1007/S00415-018-9013-6
3. Qian J, Zhang Y, Betensky RA, et al. 147th Annual Meeting American Neurological Association. Ann Neurol. 2022;92(S29):S1-S243. doi:10.1002/ANA.26484

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MDS Abstracts - https://www.mdsabstracts.org/abstract/racial-and-ethnic-differences-in-suicidal-ideation-in-north-american-patients-with-huntingtons-disease-analysis-using-the-enroll-hd-dataset/