Global Prevalence and Risk Factors of Suicidal Ideation in Multiple Sclerosis: A Systematic Review and Meta-Analysis

Suicidal ideation (SI), attempts, and death have been frequently described and investigated in chronic neurological disorders such as Multiple Sclerosis (MS). This systematic review and meta-analysis estimated the global prevalence of SI in patients with MS and demonstrated associated risk factors. This may help the physician to reduce the rate of suicidal attempts and improve public health.

A comprehensive systematic search was performed on PubMed, Scopus, Embase, and Web of Science to find studies that reported the prevalence of SI or its related factors in MS patients. Studies were screened by the title/abstract and then by their full text. Data extraction was performed for relevant studies. A point prevalence with a 95% confidence interval was estimated. Random-effect meta-analysis was conducted to assess the pooled prevalence of SI.

From the 1246 total studies that were found, we included 18 final eligible studies for systematic review and 16 studies for meta-analysis. The prevalence of SI in multiple sclerosis patients was estimated at 20% (95% CI [15-25]), based on random-effect meta-analysis. Among the included studies, higher rates of depression and anxiety, lower family and social support, longer duration of illness, and higher levels of disability were related risk factors for SI in patients with MS.

Given the higher prevalence of SI in people with MS than in the general population, it should be considered during routine clinical visits and psychological evaluations. Proper counseling, psychological support, and psychiatric interventions may reduce the lifetime risks and help patients overcome their suicidal thoughts.