{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T08:32:58Z","timestamp":1780734778749,"version":"3.54.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T00:00:00Z","timestamp":1615766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Due to the high prevalence of suicidal ideation in Parkinson's Disease (PD) and exploratory data indicating a similar prevalence in atypical Parkinsonian disorders (APD), we sought to determine the frequency of assisted suicide (AS) as well as factors driving these decisions in PD and APD.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Retrospective chart analysis (2006-2012) at a Swiss Right-to-Die organization. Patients with PD and APD who completed AS were analyzed concerning disease state, symptom burden, medication, and social factors.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> We identified 72 patients (PD = 34, PSP = 17, MSA = 17, CBS = 4; 7.2% of all AS cases), originating mainly from Germany (41.7%), Great Britain (29.2%), and the US (8.3%). Predominant symptoms at the time of application were immobility (PD\/APD: 91%\/97%), helplessness (63%\/70%), pain (69%\/19%), dysarthria (25%\/32%), and dysphagia (19%\/59%). APD patients generally showed a higher symptom burden and a higher frequency of diagnosed depression (8.8%\/28.9%). While most patients with diagnosed depression received antidepressants (80%), other symptoms such as pain (59%) were treated less consistently. Of note, time from diagnosis to application differed greatly between PD (8.5 \u00b1 6.8 years) and APD (1.5 \u00b1 1.3 years, <jats:italic>p<\/jats:italic> &amp;lt; 0.0001).<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> In our analysis, Parkinsonian disorders appeared to be overrepresented as a cause of AS considering the prevalence of these diseases. The observation that assisted suicide is sought early after initial diagnosis in APD implies the need for early comprehensive psychological support of these patients and their relatives.<\/jats:p>","DOI":"10.3389\/fneur.2021.656599","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T05:06:57Z","timestamp":1615784817000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Assisted Suicide in Parkinsonian Disorders"],"prefix":"10.3389","volume":"12","author":[{"given":"Georg S.","family":"Nuebling","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Butzhammer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Lorenzl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,3,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1097\/00002826-199308000-00006","article-title":"Retrospective study of drug response in 87 patients with progressive supranuclear palsy","volume":"16","author":"Nieforth","year":"1993","journal-title":"Clin Neuropharmacol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1136\/jnnp-2018-319815","article-title":"Suicide in Parkinson's disease","volume":"90","author":"Shepard","year":"2019","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2720","DOI":"10.1093\/brain\/awn214","article-title":"A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease","volume":"131","author":"Voon","year":"2008","journal-title":"Brain"},{"key":"B4","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1002\/gps.2194","article-title":"Parkinson's disease and suicide: a profile of suicide victims with Parkinson's disease in a population-based study during the years 1988-2002 in Northern Finland","volume":"24","author":"Mainio","year":"2009","journal-title":"Int J Geriatr Psychiatry."},{"key":"B5","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1177\/089198870101400304","article-title":"Are patients with Parkinson's disease suicidal?","volume":"14","author":"Myslobodsky","year":"2001","journal-title":"J Geriatr Psychiatry Neurol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.jns.2009.08.016","article-title":"Suicide and suicidal ideation in Parkinson's disease","volume":"289","author":"Kostic","year":"2010","journal-title":"J Neurol Sci."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1002\/mds.22130","article-title":"Suicidal and death ideation in Parkinson's disease","volume":"23","author":"Nazem","year":"2008","journal-title":"Mov Disord"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1016\/j.psychres.2013.08.045","article-title":"Behavioral abnormalities in progressive supranuclear palsy","volume":"210","author":"Gerstenecker","year":"2013","journal-title":"Psychiatry Res"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1002\/mds.22794","article-title":"A comparison of depression, anxiety, and health status in patients with progressive supranuclear palsy and multiple system atrophy","volume":"25","author":"Schrag","year":"2010","journal-title":"Mov Disord."},{"key":"B10","doi-asserted-by":"publisher","first-page":"E668","DOI":"10.1503\/cmaj.190082","article-title":"Shelly, MAiD and the purple parade","volume":"191","author":"Linkins","year":"2019","journal-title":"CMAJ."},{"key":"B11","first-page":"306","volume-title":"BMJ","author":"Anne","year":"2006"},{"key":"B12","volume-title":"Suizidalit\u00e4t bei Patienten mit atypischen Parkinsonsyndromem - 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