Marcel Henrique Silva-Moraes1, Ana Cecília Bispo-Torres1, Judah L Barouh2, Pedro H Lucena3, Giulia Armani-Franceschi1, Ingrid Dorea-Bandeira4, Flavia Vieira5, Ângela Miranda-Scippa6, Lucas C Quarantini7, Rita Lucena6, Igor D Bandeira8. 1. Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil. 2. Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil; Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Harvard University, Boston, United States. 3. Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil. 4. Faculdade de Tecnologia e Ciências, Salvador, Brazil; Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil. 5. Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Praça XV de Novembro, s/n - Largo do Terreiro de Jesus, Salvador, Bahia, Brazil. 6. Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil. 7. Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil; Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil. 8. Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Praça XV de Novembro, s/n - Largo do Terreiro de Jesus, Salvador, Bahia, Brazil. Electronic address: igordbandeira@gmail.com.
Abstract
BACKGROUND: Amyotrophic Lateral Sclerosis (ALS) leads to a drastic reduction in quality of life, generating intense psychological distress and predisposing those affected to mental illness and, in more severe cases, suicidal behavior. OBJECTIVE: This is a systematic review aiming to estimate the frequency of wish to die, suicide ideation and suicide in individuals with ALS using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). METHODS: The following databases were used: Pubmed/MEDLINE, PsycINFO, Embase, SciELO, Biblioteca Virtual de Saúde (BVS), and Cochrane Library. The choice of appropriate descriptors, or their equivalents, to define the search terms was based on the technical and scientific vocabulary of each database. RESULTS: 13 articles were included in the present systematic review, of which three were cross-sectional studies, nine were cohort-type and there was one case-control study. The studies show that individuals with ALS have a higher risk of suicide in relation to the general population, and there is evidence that this risk is even higher in the early stages of the disease. Major Depressive Disorder was the most prevalent mental disorder in the studies included. This mental health concern is often undertreated, leading to the increased susceptibility of this population to suicide. LIMITATIONS: In general, the study samples represent a highly heterogeneous population while many instruments used in the data collection were not uniform. CONCLUSIONS: The high degree of psychological vulnerability of this population, associated with a greater predisposition to suicidal behavior, should be minimized through public health measures.
BACKGROUND:Amyotrophic Lateral Sclerosis (ALS) leads to a drastic reduction in quality of life, generating intense psychological distress and predisposing those affected to mental illness and, in more severe cases, suicidal behavior. OBJECTIVE: This is a systematic review aiming to estimate the frequency of wish to die, suicide ideation and suicide in individuals with ALS using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). METHODS: The following databases were used: Pubmed/MEDLINE, PsycINFO, Embase, SciELO, Biblioteca Virtual de Saúde (BVS), and Cochrane Library. The choice of appropriate descriptors, or their equivalents, to define the search terms was based on the technical and scientific vocabulary of each database. RESULTS: 13 articles were included in the present systematic review, of which three were cross-sectional studies, nine were cohort-type and there was one case-control study. The studies show that individuals with ALS have a higher risk of suicide in relation to the general population, and there is evidence that this risk is even higher in the early stages of the disease. Major Depressive Disorder was the most prevalent mental disorder in the studies included. This mental health concern is often undertreated, leading to the increased susceptibility of this population to suicide. LIMITATIONS: In general, the study samples represent a highly heterogeneous population while many instruments used in the data collection were not uniform. CONCLUSIONS: The high degree of psychological vulnerability of this population, associated with a greater predisposition to suicidal behavior, should be minimized through public health measures.
Keywords:
Amyotrophic lateral sclerosis; Depression; Major Depressive Disorder; Motor neuron disease; Suicidal behavior; Suicidal ideation; Suicide; Wish to die
Authors: Rachel Silvany Quadros Guimarães; Igor D Bandeira; Bianca Lima Barretto; Thiago Lima Barretto; Thamires Wanke; Clara Oliveira Carvalho Alves; Chrissie Ferreira de Carvalho; Pedro H Lucena; Luciana Rodrigues-Silva; Rita Lucena Journal: Medicine (Baltimore) Date: 2021-02-26 Impact factor: 1.889