Ecole des Hautes Etudes en Santé Publique (EHESP), Département METIS, Rennes Cedex, France.
Service de Neurologie and CIC-P 1414, CHU de Rennes, Rennes Cedex, France.
Mult Scler. 2017 May;23(6):864-871. doi: 10.1177/1352458517699873. Epub 2017 Mar 16.
Few recent studies have shown that there is no longer an increased risk of suicide in patients affected with multiple sclerosis (MS).
To describe suicide cases within a large French MS cohort and assess whether MS patients are at a higher risk of suicide compared with the general population.
Data derives from a study on long-term mortality of 27,603 prevalent cases from 15 MS specialist centres. Of 1,569 deceased MS patients (5.7%) on 1 January 2010, 47 were suicides.
The mean time between MS clinical onset and death was 13.5 years (standard deviation (SD): 9.3 years; none within the first 3 years) and was significantly shorter than for MS patients who had died from other causes (mean = 21.4 (SD = 11.6), p < 0.0001). Age at death was also lower (46.3 vs 56.7). The standardized mortality rates were around 1 in several sensitivity analyses, reflecting no excess mortality in MS compared with general population.
Our findings indicate that an excess suicide risk may no longer be true for MS patients and highlight the changing profile of cases, occurring later in the disease course. Further studies in population-based registries are needed to confirm and explain these potential changes (e.g. treatments' impact?).
最近的几项研究表明,多发性硬化症(MS)患者自杀风险不再增加。
描述大型法国 MS 队列中的自杀病例,并评估 MS 患者与普通人群相比自杀风险是否更高。
数据来自对 15 个 MS 专家中心的 27603 例现患病例进行的长期死亡率研究。在 2010 年 1 月 1 日之前死亡的 1569 例 MS 患者中(5.7%),有 47 例自杀。
MS 临床发病至死亡的平均时间为 13.5 年(标准差(SD):9.3 年;无 3 年内死亡),明显短于因其他原因死亡的 MS 患者(平均=21.4(SD=11.6),p<0.0001)。死亡时的年龄也较低(46.3 岁 vs 56.7 岁)。在几项敏感性分析中,标准化死亡率约为 1,反映 MS 患者的死亡率与普通人群相比没有增加。
我们的发现表明,MS 患者的自杀风险可能不再过高,并强调了病例发生的变化情况,即发生在疾病过程的后期。需要在基于人群的登记处进行进一步研究以确认和解释这些潜在变化(例如治疗的影响?)。