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Suicidal thinking in multiple sclerosis
Aviva Gaskill1, Frederick W Foley, Julie Kolzet
1Ferkauf Graduate School of Psychology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Purpose:
Studies demonstrate that suicidal ideation (SI) is greater in persons with multiple sclerosis (MS) than in the general population. SI may offer some MS patients a mechanism for feeling in control of their lives, in the face of a daunting, unpredictable disease. In this study, we determined what specific mental constructs or perceptual themes occur for MS patients experiencing SI, while also examining the construct of 'control' as a central theme.
Methods:
Individual interviews (N = 16) were audiotaped, transcribed and qualitatively analysed by two independent raters to test for key themes in MS patients reporting SI.
Results:
In relation to SI, eight key themes were identified by both raters as having been expressed in interviews: perceived loss of control, increased family tension, loneliness, hopelessness and frustration, physical and psychological impact of MS, loss of perceived masculinity or femininity, regaining control and failure to achieve desired or expected role functioning. We created a model to explain the emergence of these themes as they contribute to SI among patients with MS. All participants indicated that perceived loss of control elicited thoughts of suicide.
Conclusion:
Perceived loss of control appears to be a major disease related burden associated with SI in MS patients.
Insights
Suicidal ideation in multiple sclerosis (MS) patients is strongly linked to a perceived loss of control. Understanding these themes is crucial for supporting MS individuals experiencing such thoughts.
Area of Science:
- Neurology
- Psychiatry
- Qualitative Health Research
Background:
- Suicidal ideation (SI) is more prevalent in multiple sclerosis (MS) patients compared to the general population.
- For some individuals with MS, SI may represent a coping mechanism to exert control over an unpredictable disease.
- The psychological burden of MS necessitates understanding the specific themes associated with SI in this population.
Purpose of the Study:
- To identify specific mental constructs and perceptual themes experienced by MS patients with suicidal ideation.
- To investigate the role of 'control' as a central theme in the context of SI among individuals with MS.
Main Methods:
- Qualitative analysis of individual interviews with 16 MS patients reporting SI.
- Interviews were audiotaped, transcribed, and analyzed by two independent raters to identify key themes.
Main Results:
- Eight key themes emerged: perceived loss of control, family tension, loneliness, hopelessness, frustration, physical/psychological impact of MS, altered gender roles, regaining control, and role functioning issues.
- A model was developed to explain how these themes contribute to SI in MS patients.
- All participants identified a perceived loss of control as a trigger for suicidal thoughts.
Conclusions:
- A perceived loss of control is a significant disease-related burden contributing to suicidal ideation in patients with multiple sclerosis.
- Addressing the theme of control may be a critical component in interventions for SI in MS.
- Further research into the psychological impact of MS and its relation to SI is warranted.
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