ClinicSpeak: suicide in Swedish MSers

Are you depressed? Please download the Beck Depression Inventory and assess yourself. #ClinicSpeak #MSBlog #MSResearch

"The article below complements my post yesterday on loneliness and social isolation; it confirms that pwMS are at increased risk of both attempted suicide and completed suicide. Men are more successful at committing suicide than women. These are rather depressing figures, but as MS is strongly associated with depression they are not surprising. What can be done about it? All pwMS should be screened for depression and suicidal ideation, or suicidal thoughts, and if they are found to be at risk they should be offered help. Easier said than done? In a recent audit of our service a glaring omission was the patchy screening for depression in our MS clinics. I have included the Beck Depression inventory that you can download and score yourself. If you find you are depressed please see your GP, neurologist or MS CNS."

Brenner et al. Multiple sclerosis and risk of attempted and completed suicide - a cohort study. Eur J Neurol. 2016 Apr 27. 

BACKGROUND AND PURPOSE: Patients with multiple sclerosis (MS) are known to have an elevated suicide risk, but attempted suicide is incompletely investigated. The relation between education level and suicidality has not been investigated in MS patients. Our objective was to estimate attempted suicide and completed suicide risks amongst MS patients.

METHODS: A total of 29 617 Swedish MS patients were identified through the Swedish Patient Register and matched with 296 164 people without MS from the general population. Cox regression analysis estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for the association of MS with attempted and completed suicide, with adjustment for age, sex, education and calendar period.

RESULTS: The adjusted HR for attempted suicide amongst MS patients is 2.18 (95% CI 1.97-2.43) compared with the general population cohort. For completed suicide the HR is 1.87 (95% CI 1.53-2.30). In both groups women are at higher risk of attempting  suicide, whilst men are at higher risk of completing suicide. Education level is inversely associated with completed suicide amongst the non-MS cohort (0.68, 0.51-0.91), but not amongst MS patients (1.10, 0.60-2.04).

CONCLUSION: Multiple sclerosis patients are at higher risk of both attempted and completed suicide. No evidence was found of an inverse association between educational level and risk of completed suicide amongst MS patients. 

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