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Suicidal ideation in the year following diagnosis of relapsing-remitting multiple sclerosis: A longitudinal
David C Gillespie1, Riccardo Sacripante2, Siddharthan Chandran3
1Department of Clinical Neurosciences (DCN), Royal Infirmary of Edinburgh, 50 Little France Crescent, Edinburgh, UK, EH16 4TJ; Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, 49 Little France Crescent, Edinburgh, EH16 4SB, UK.
Introduction:
Suicidal ideation (SI) is common in people with multiple sclerosis (pwMS) who have longstanding illness. Prevalence of SI in the weeks to months following diagnosis is unknown, as are factors associated with SI, and whether SI 'settles' over time for newly diagnosed individuals.
Methods:
We investigated SI in the FutureMS cohort, a nationally-representative relapsing-remitting MS sample (n = 440) recruited within weeks of diagnosis. SI was considered soon ('baseline'; median 60 days) and 12 months after diagnosis. A validated mood screen classified individuals SI/non-SI. We analysed associations of clinico-demographic variables with SI and change in SI status.
Results:
SI was present in 12.8 % (95 % CI = 0.10, 0.16) at baseline. Those with SI had greater disability and were more likely to be anxious, depressed, fatigued, report toileting difficulties and spasms. In regression analysis, baseline SI was associated with anxiety (p < 0.001) and depression (p = 0.002), though 16 % of those reporting SI scored just 'mild' for depression. At 12 months, 9.6 % (95 % CI = 0.07, 0.13) reported SI, non-significantly different than baseline. Individuals with poorest SI outcomes over 12 months had greater unemployment, disability, anxiety, depression, fatigue, toileting difficulties and spasms, but in regression analysis no variable was individually associated with SI change.
Limitations:
SI is complex but measured in this study by single-item question.
Conclusion:
SI soon after MS diagnosis is relatively common, not only when anxiety and depression are present, but also in individuals with only mild depression. Screening for SI is important, allowing clinicians to target support to newly diagnosed individuals.
Insights
Suicidal ideation is common in newly diagnosed multiple sclerosis patients. Early screening is crucial, as ideation persists and is linked to anxiety and depression.
Area of Science:
- Neurology
- Psychiatry
- Epidemiology
Background:
- Suicidal ideation (SI) is prevalent in long-standing multiple sclerosis (MS).
- The prevalence, associated factors, and temporal changes of SI in early MS are largely unknown.
- Understanding early SI is critical for timely intervention in newly diagnosed individuals.
Purpose of the Study:
- To determine the prevalence of SI in the weeks to months following a new diagnosis of MS.
- To identify factors associated with SI in early MS.
- To examine whether SI changes over the first year post-diagnosis.
Main Methods:
- The FutureMS cohort, a national sample of 440 individuals with relapsing-remitting MS within weeks of diagnosis, was studied.
- Suicidal ideation was assessed at baseline (median 60 days post-diagnosis) and 12 months.
- Validated mood screening tools and clinico-demographic variables were used to analyze SI and its associations.
Main Results:
- At baseline, 12.8% of individuals reported SI, associated with greater disability, anxiety, depression, fatigue, toileting issues, and spasms.
- Anxiety and depression were significantly associated with baseline SI.
- At 12 months, 9.6% reported SI, a non-significant change from baseline. No single factor predicted SI change over time.
Conclusions:
- Suicidal ideation is relatively common soon after MS diagnosis, even with mild depression.
- SI in early MS is complex and associated with various symptoms and disability.
- Screening for SI in newly diagnosed MS patients is essential for targeted support.
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