Suicide prevention in neurology patients: evidence to guide practice.

OBJECTIVE: This article is an overview of the neurological diagnoses with highest attempt in suicide. The most common risk factors in suicidal ideation in neurology patients are identified, as well as the description of ways to assess and implement treatment of patients with suicidal ideation, including the recommendations for patients with specific neurological diagnosis. A guideline development is needed to address suicide concerns in these patients.
METHODS: A literature search was conducted to find published studies and patient guidelines that were relevant to suicidal ideation, assessment, and treatment in neurology patients.
RESULTS: Information found was not always exclusive for neurology patients. Findings often discussed psychiatric patients. The neurological diagnosis most associated with suicidal ideation includes multiple sclerosis, epilepsy, and Parkinson's disease. The most common risk factors for suicidal ideation are hopelessness, depression, and social isolation. As treatment factors, a therapeutic relationship, treatment for depression, assurance of patient safety, and specific interventions for suicidal prevention were identified to provide healthcare professionals in neurology ways to address suicidal issues for patients with neurological diagnoses. Three protocols highlighted staff prevention activities. DISCUSSION: Because patients with neurological disorders experience suicidal ideation with a greater risk of suicide, particularly in multiple sclerosis, epilepsy, and Parkinson's disease, the potential risk for suicide requires active assessment, monitoring, and intervention by nurses and health professionals to address this clinical issue. The assessments available require further psychometric testing for reliability and validity with patient use. There is a need for more research to develop a guideline/protocol exclusively for neurological patients.