Rebecca Viner1, Scott B Patten2, Sandra Berzins1, Andrew G M Bulloch3, Kirsten M Fiest1. 1. Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Canada. 2. Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Canada; Department of Psychiatry and Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada. Electronic address: patten@ucalgary.ca. 3. Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Canada; Department of Psychiatry and Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada.
Abstract
OBJECTIVE: To estimate the prevalence, incidence and determinants of suicidal ideation in the multiple sclerosis (MS) population. METHODS: A sample of 188 subjects were randomly selected from a community-based MS clinic registry and participated in as many as 13 interviews over 6 months. Thoughts of "being better off dead" or of "harming oneself" were assessed using item 9 on the Patient Health Questionnaire, Brief (PHQ-9). RESULTS: At baseline, the 2-week period prevalence of suicidal ideation was 8.3%. Over the course of 6 months, 22.1% of respondents reported having such thoughts at least once. Survival analysis incorporating baseline PHQ-8 scores as a covariate confirmed that being age 65 and over (HR=4.3, 95% CI 1.7-11.3) and having lower quartile self-efficacy ratings (HR=3.5, 95% CI 1.5-8.2) predicted suicidal ideation. Lower levels of task-oriented coping (treated as a continuous variable) also predicted suicidal ideation after adjustment for depressive symptoms (p=0.015), as did self-reported bladder or bowel symptoms (HR=2.6, 95% CI 1.1-6.0) and difficulties with speaking and swallowing (HR=2.9, 95% CI 1.3-6.8). Associations with MS symptoms were not confounded by depressive symptoms. CONCLUSION: This study identified several potentially modifiable factors that may be useful for preventing suicide in people with MS.
OBJECTIVE: To estimate the prevalence, incidence and determinants of suicidal ideation in the multiple sclerosis (MS) population. METHODS: A sample of 188 subjects were randomly selected from a community-based MS clinic registry and participated in as many as 13 interviews over 6 months. Thoughts of "being better off dead" or of "harming oneself" were assessed using item 9 on the Patient Health Questionnaire, Brief (PHQ-9). RESULTS: At baseline, the 2-week period prevalence of suicidal ideation was 8.3%. Over the course of 6 months, 22.1% of respondents reported having such thoughts at least once. Survival analysis incorporating baseline PHQ-8 scores as a covariate confirmed that being age 65 and over (HR=4.3, 95% CI 1.7-11.3) and having lower quartile self-efficacy ratings (HR=3.5, 95% CI 1.5-8.2) predicted suicidal ideation. Lower levels of task-oriented coping (treated as a continuous variable) also predicted suicidal ideation after adjustment for depressive symptoms (p=0.015), as did self-reported bladder or bowel symptoms (HR=2.6, 95% CI 1.1-6.0) and difficulties with speaking and swallowing (HR=2.9, 95% CI 1.3-6.8). Associations with MS symptoms were not confounded by depressive symptoms. CONCLUSION: This study identified several potentially modifiable factors that may be useful for preventing suicide in people with MS.
Authors: Aaron P Turner; Kevin N Alschuler; Abbey J Hughes; Meghan Beier; Jodie K Haselkorn; Alicia P Sloan; Dawn M Ehde Journal: Curr Neurol Neurosci Rep Date: 2016-12 Impact factor: 5.081