An examination of suicidal intent in patients with multiple sclerosis

Neurology. 2002 Sep 10;59(5):674-8. doi: 10.1212/wnl.59.5.674.


Objective: To examine neurologic and psychiatric correlates of suicidal intent in a community sample of 140 patients with MS.

Methods: Patients with (28.6%) and without lifetime suicidal intent were compared across MS disease-related and psychiatric variables. All subjects were interviewed with 1) the Structured Clinical Interview for DSM-IV Axis 1 disorders (SCID-IV) to determine lifetime prevalence of major depression and anxiety disorders; and 2) the Social Stress and Support Interview to assess psychological stressors. Suicidal intent was documented with questions from the SCID-IV and Beck Suicide Scale. Patients also completed the Hospital Anxiety and Depression Scale and cognitive testing.

Results: Suicidal patients were significantly more likely to live alone, have a family history of mental illness, report more social stress, and have lifetime diagnoses of major depression, anxiety disorder, comorbid depression-anxiety disorder, and alcohol abuse disorder. By logistic regression analysis, the severity of major depression, alcohol abuse, and living alone had an 85% predictive accuracy for suicidal intent. A third of suicidal patients had not received psychological help. Two-thirds of subjects with current major depression, all suicidal, had not received antidepressant medication.

Conclusions: Suicidal intent, a potential harbinger for suicide, is common in MS and is strongly associated with major depression, alcohol abuse, and social isolation. Suicidal intent is a potentially treatable cause of morbidity and mortality in MS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / psychology*
  • Female
  • Humans
  • Interview, Psychological
  • Logistic Models
  • Male
  • Middle Aged
  • Multiple Sclerosis / epidemiology
  • Multiple Sclerosis / psychology*
  • Predictive Value of Tests
  • Risk Factors
  • Suicide / psychology*