Suicidal Ideation in Patients With Multiple Sclerosis and Its Association With Clinical and Demographic Characteristics

Abstract

Background

Chronic neurological diseases, such as multiple sclerosis (MS) are important risk factors for some psychological disorders, such as depression and consequently suicidal behavior. As suicidal ideation (SI) is one of the important factors in predicting suicide attempts and suicide deaths, the recognition of factors related to the occurrence of SI in patients with MS has high value.

Objective

This study aims to assess the association between sociodemographic, psychological, and disease characteristics with SI in patients with MS.

Methods

A sample of 400 subjects with MS was selected from a referral outpatient MS clinic in Tehran, Iran (2024). Participants completed a personal information questionnaire, the patient health questionnaire-9 (PHQ-9), the hospital anxiety and depression scale (HADS), and the beck scale for suicidal ideation (BSSI). Logistic regression models (univariate and multivariate) were conducted to determine the association between each variable and SI using odds ratio (OR) and 95% confidence interval (CI). Finally, the correlation between depression, anxiety, and the SI scale was measured by bivariate Pearson correlation analyses.

Results

The sample consisted of 77% women, and the mean age was 36.91 years. Among them, 149 (37.2%) of cases were identified with suicidal ideation at some period in life. Findings in the multivariate regression model represented that an increase in age had a significant protective effect on SI (adjusted OR [AOR] 0.95, 95% CI 0.92 to 0.98, p = 0.003). Moreover, the history of previous suicide attempts doubled the odds of SI (AOR 2.18, 95% CI 1.05 to 4.54, P = 0.038). Finally, both depression score (measured by PHQ-9) and anxiety score (measured by HADS) had significant associations with SI.

Conclusion

People with MS are highly prone to suicidal thoughts and even suicide attempts; this should not be ignored in routine clinical visits due to other physical complaints. They need to be discussed with patients, and effective psychiatric interventions should be applied to reduce the risks.