School of Medicine, Vanderbilt University, Nashville, TN, USA
Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
Correspondence to: Daniel O. Claassen, MD, MS, Vanderbilt University, Department of Neurology, 1161 21st Avenue South A-0118, Nashville, TN 37232-2551, USA. Tel.: +1 615 936 1007; Fax: +1 615 343 3946; E-mail: email@example.com.
Abstract: 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.