Sep. 17, 2002
Suicidal intent is frequently found in patients with MS but is more often associated with depression, alcohol abuse and social isolation than with level of disability, according to the results of a recent study.
The study compared MS disease-related and psychiatric variables in 140 patients. Subjects were interviewed to determine lifetime prevalence of major depression and anxiety disorders, psychological stressors, cognitive impairment and lifetime suicidal intent.
The researchers found that the lifetime prevalence of suicidal intent in this group was 28.6 percent (40 subjects) and that nine subjects (6.4 percent) had attempted suicide. A comparison between patients who had suicidal intent at some point in the past and those who never had suicidal intent showed no demographic (age, marital status and employment status) or MS disease-related (physical disability, disease duration and course, and cognitive dysfunction) differences between the groups.
However, suicidal patients were significantly more likely to be living alone, to have a family history of mental illness, to experience more social stress and to have a higher lifetime prevalence of major depression, anxiety disorder, co-existing depression plus anxiety disorder or an alcohol abuse disorder.
Study results indicated that 31.4 percent of patients with a lifetime diagnosis of major depression and 35 percent of patients with lifetime suicidal intent had received neither antidepressant medication nor psychotherapy. Moreover, six of the nine patients with a current diagnosis of major depression, all of whom were harboring suicidal intent, were not on antidepressant medication.
All of the nine patients who had attempted suicide had received a lifetime diagnosis of major depression, but four had never been given antidepression medication.
"Of concern is that a third of patients with MS with a lifetime diagnosis of major depression had not received antidepressant medication and did not have their mental health addressed by a family doctor, neurologist, psychotherapist or counselor," the study authors noted.
"These omissions should be viewed within the context of an emerging literature that has demonstrated the efficacy of many antidepressant drugsâ€¦in the treatment of major depression associated with MS."
Study results appeared in the Sept. 10 issue of Neurology.
© 2002, FaxWatch