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Risk factors for suicide in multiple sclerosis
E N Stenager1, N Koch-Henriksen, E Stenager
1Clinical Neuropsychiatric Research Unit, Odense University Hospital, Denmark.
Background:
The purpose of the present study was to identify risk factors for suicide in patients with multiple sclerosis (MS).
Methods:
The study is based on available information about MS patients identified in the Danish MS Registry (DMSR) with onset in the period 1950-1985. We compared the MS suicides with the 1950-1985 onset cohort patients in the DSMR as to distribution of age at onset, presenting symptoms, and time from onset to diagnosis. We reviewed sociodemographic data, age of onset, the course of the disease, recent deterioration, type of deterioration, Kurtzke Disability Status Scale (DSS) score, previous mental disorder, type of mental disorder, previous suicide attempts, expression of suicidal intentions, circumstances at suicide, and suicide method for all MS patients who had committed suicide. In order to characterize MS suicides with respect to risk factors, comparisons were made for male and female suicides and for various groups of MS suicides according to disability status.
Results:
The male suicide patients were characterized by a tendency to commit suicide in the age interval 40-49 years, by the use of a violent suicide method, by previous suicidal behaviour, by a previous mental disorder, by recent deterioration of MS, and by a moderate disability. For women the characteristics were less distinct. Patients with a severe course of MS had been subjected to more risk factors before the suicide than patients with a moderate course of the disease.
Conclusion:
Careful counselling and good information on all aspects of the disease, especially in the first stages and at time of progression, could be an instrument of prevention of suicides in MS patients. Furthermore, recognition and treatment of depression and pain is important.
Insights
Identifying suicide risk factors in multiple sclerosis (MS) patients is crucial. Male MS patients with moderate disability, previous mental disorders, and recent deterioration showed higher suicide risks.
Area of Science:
- Neurology
- Psychiatry
- Epidemiology
Background:
- Multiple sclerosis (MS) is a chronic neurological disease.
- Suicide is a significant concern in patients with MS.
Purpose of the Study:
- To identify specific risk factors associated with suicide in patients diagnosed with multiple sclerosis.
- To analyze demographic and clinical data to understand suicide patterns in MS.
Main Methods:
- Utilized data from the Danish Multiple Sclerosis Registry (DMSR) for patients with onset between 1950-1985.
- Compared suicide cases with a control cohort from the DMSR.
- Analyzed sociodemographic data, disease course, disability status (Kurtzke Disability Status Scale), mental health history, and suicide circumstances.
Main Results:
- Male MS patients who died by suicide were often aged 40-49, used violent methods, had prior suicidal behavior, existing mental disorders, recent MS deterioration, and moderate disability.
- Female MS suicide characteristics were less defined.
- Patients with a severe MS disease course faced more risk factors preceding suicide compared to those with a moderate course.
Conclusions:
- Proactive patient counseling and comprehensive disease education, particularly during early stages and disease progression, can aid suicide prevention in MS.
- Effective recognition and management of depression and pain are vital for mitigating suicide risk.