Multiple sclerosis and risk of completed and attempted suicide - a national cohort study

• Published in: MULTIPLE SCLEROSIS JOURNAL Vol. 21; no. Suppl. 11; p. 23
• Main Authors: Brenner, P., Burkill, S., Jokinen, J., Moore, A., Geissbuehler, Y., Hillert, J., Bahmanyar, S., Montgomery, Scott
• Format: Journal Article Conference Proceeding
• Language: English
• Published: 2015
• Subjects: Medicin och hälsovetenskap; Neurologi; Neurology
• ISSN: 1477-0970; 1352-4585
• DOI: 10.1177/1352458515602640

Introduction : Patients with multiple sclerosis (MS) are known to have an elevated suicide risk, but attempted suicide is incompletely investigated. Objectives : To estimate attempted suicide and completed suicide risks among MS patients using national registers and to assess if the inverse association of higher-level education with completed suicide is affected by MS. Methods : A total of 29,617 Swedish MS patients were identified through the Swedish Patient Register and matched (by birth year, sex, vital status at diagnosis and region) with 296,164 people without MS from the general population. Cox regression estimated hazard ratios (HR) (with 95% confidence intervals) for the association of MS with attempted and completed suicide, with adjustment for age, sex, education level, decade of study entry, and previous suicide attempts. Results : The adjusted HR for attempted suicide among MS patients is 2.18 (1.97-2.43) compared with the general population cohort. For completed suicide the HR is 1.87 (1.53-2.30). Overall, men were at higher risk of completing suicide, while women were at higher risk of attempting suicide. Higher education is inversely associated with completed suicide among the non-MS cohort with an HR of 0.68, (0.51-0.91), but not among MS patients, where the HR is 1.10, (0.60-2.04). MS patients were less likely to use a violent method than the non-MS cohort. Conclusion : MS patients are at higher risk of both attempted and completed suicide, and the risk increase is present in both men and women. Possibly the stress and perceived prognosis associated with an MS diagnosis increases the risk of suicide. MS appears to eliminate the protective association of higher education with completed suicide.