Suicide Determinants in Multiple Sclerosis

Background: Major depressive disorders and suicide are highly common among patients with MS. Despite the high prevalence of suicide ideation among persons with MS, only half of patients are screened and depression and suicide ideation often remain undetected.

Objectives: The purpose of this cross-sectional study was to evaluate the prevalence and predictors of suicide in MS as measured by the Beck Depression Inventory II (BDI-II) and Beck Depression Inventory Fast Screen (BDI-FS), and to determine if the degree of disability and relapse rate were associated with suicide ideation.

Methods: A cross-sectional observational study was conducted and a convenience sample of 34 persons with MS was recruited from an urban neurological clinic. Descriptive statistics, Spearman correlation, and logistic regression were used to analyze the data.

Results: The sample was primarily female (71%), Caucasian (73.5%), married (56%), educated, and lived with a partner or their family (68%). The prevalence of suicide as assessed by the BDI-FS and BDI-II was 11.76% and was associated with subjects who were not married, not Caucasians, and who lived alone. Symptoms predictive of suicidal ideation were major depression, appetite changes, sadness and loss of pleasure (p<.05). Mann-Whitney analysis has shown a higher rank for higher MS relapses and suicide ideation (p<.05), but there was no association between disability and suicide ideation.

Conclusions: Depression, appetite changes, sadness and loss of pleasure are determinants of suicide in MS. Early screening with the BDI-FS is critical in clinical practice. Larger studies are warranted to identify suicide determinants in MS and the influence of disability and MS relapses upon suicide ideation.

Key Words: Suicide, Depression, Multiple Sclerosis.