Fatigue Is Associated with Suicidal Thoughts in Multiple Sclerosis

Background: Individuals with multiple sclerosis (MS) are more than twice as likely as those in the general population to attempt suicide. Fatigue is among the most common MS complaints, with patients often counting it among their most disabling symptoms. To date, little research has investigated how feelings of fatigue may contribute to thoughts of suicide in the MS population.

Objectives: To investigate how suicidal ideation (SI) in persons with MS may be related to different types of fatigue.

Methods: Retrospective chart review of patients (N = 65) from a large tertiary MS center in New Jersey was conducted. Presence of suicidal thoughts was determined by responses on item 9 the Patient Health Questionnaire – 9 (PHQ) and Beck Depression Inventory – II (BDI), where a response of 1 or higher on either scale was considered an endorsement of SI. Patients had completed the Fatigue Scale for Motor and Cognitive Functions (FSMC). A series of Mann-Whitney U tests was conducted to compare scores between patients endorsing and not endorsing suicidal thoughts.

Results: FSMC total score (p = .004), as well as scores on the FSMC cognitive fatigue (p = .008) and motor fatigue subscales (p = .001), were significantly higher in patients who endorsed SI than those who did not.

Conclusions: Fatigue appears to be associated with suicidality in persons with MS. Healthcare providers and family members should be aware that highly fatigued patients may be at greater risk of having suicidal thoughts.