Predictors of Suicidal Ideation in Multiple Sclerosis

Abstract

Few studies have been published highlighting risk factors and predictors of suicidal ideation in people with multiple sclerosis (MS). Both suicide and suicidal ideation are serious issues in MS, with attempted and completed suicides far higher than that of the general population, as well as in other medical and neurological conditions (Fisk, Morehouse, Brown, Skedgel, & Murray, 1998; Sadovnic, Eisen, Ebers, & Paty, 1991; Stenager & Stenager, 1992). The study of suicidal ideation in MS is imperative given that suicidal ideation is associated with elevated risk for suicide plans, attempts, and completion (Goldstein, Black, Narsallah, & Winokur, 1991; Kessler, Berglund, Borges, Nock, & Wang, 2005; Kessler, Borges, & Walters, 1999). There are several interventions believed to be effective in treating people with depression, hopelessness, and suicidal thinking (Mohr, Boudewyn, Goodkin, Bostrom, & Epstein, 2001; Mohr & Goodkin, 1999; Stoudemire, Hill, Marquardt, Dalton, & Lewinson, 1998). As there are clear clinical benefits in studying suicidal ideation in MS and this is an understudied problem, this is an area of research that requires more attention. The aim of the present study is to examine risk factors associated with suicidal ideation as well as to investigate the relationship between some of these variables in the hopes of identifying a target population of people at risk for developing suicidal ideation, a potentially deadly side effect of MS. Sequential linear regressions were run. Results of analyses found that disability scores (lower), depression scores (higher), and presence of hopelessness-depression were all significant predictors of suicidal ideation (p ≤ .05) in the fully adjusted model. Age and gender were not significant predictors of suicidal ideation (p > .05) There was a significant interaction effect between gender and depression scores, though the direction of the interaction was somewhat surprising: Women without suicidal ideation had higher scores on the BDI-II than men without suicidal ideation, whereas men with suicidal ideation had higher scores on the BDI-II than women with suicidal ideation. Results help identify some characteristics that earmark certain individuals with MS as being at risk for suicidal ideation.