Department of Clinical Neurosciences (DCN), Royal Infirmary of Edinburgh, 50 Little France Crescent, Edinburgh, UK, EH16 4TJ; Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, 49 Little France Crescent, Edinburgh, EH16 4SB, UK.
Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK, NR4 7TJ.
Mult Scler Relat Disord. 2024 Nov;91:105904. doi: 10.1016/j.msard.2024.105904. Epub 2024 Sep 23.
Suicidal ideation (SI) is common in people with multiple sclerosis (pwMS) who have longstanding illness. Prevalence of SI in the weeks to months following diagnosis is unknown, as are factors associated with SI, and whether SI 'settles' over time for newly diagnosed individuals.
We investigated SI in the FutureMS cohort, a nationally-representative relapsing-remitting MS sample (n = 440) recruited within weeks of diagnosis. SI was considered soon ('baseline'; median 60 days) and 12 months after diagnosis. A validated mood screen classified individuals SI/non-SI. We analysed associations of clinico-demographic variables with SI and change in SI status.
SI was present in 12.8 % (95 % CI = 0.10, 0.16) at baseline. Those with SI had greater disability and were more likely to be anxious, depressed, fatigued, report toileting difficulties and spasms. In regression analysis, baseline SI was associated with anxiety (p < 0.001) and depression (p = 0.002), though 16 % of those reporting SI scored just 'mild' for depression. At 12 months, 9.6 % (95 % CI = 0.07, 0.13) reported SI, non-significantly different than baseline. Individuals with poorest SI outcomes over 12 months had greater unemployment, disability, anxiety, depression, fatigue, toileting difficulties and spasms, but in regression analysis no variable was individually associated with SI change.
SI is complex but measured in this study by single-item question.
SI soon after MS diagnosis is relatively common, not only when anxiety and depression are present, but also in individuals with only mild depression. Screening for SI is important, allowing clinicians to target support to newly diagnosed individuals.
有长期病史的多发性硬化症（pwMS）患者常有自杀意念（SI）。在诊断后数周到数月内，SI 的患病率以及与 SI 相关的因素，以及新诊断个体的 SI 是否随着时间的推移“稳定”，这些都未知。
我们调查了 FutureMS 队列中的 SI，这是一个在诊断后数周内招募的具有全国代表性的复发性缓解型 MS 样本（n = 440）。SI 在诊断后不久（基线；中位数 60 天）和 12 个月时进行评估。经过验证的情绪筛查将个体分为 SI/非 SI。我们分析了临床人口统计学变量与 SI 以及 SI 状态变化的关联。
基线时 SI 占 12.8%（95%CI = 0.10, 0.16）。有 SI 的人残疾程度更高，更有可能焦虑、抑郁、疲劳、报告如厕困难和痉挛。在回归分析中，基线 SI 与焦虑（p < 0.001）和抑郁（p = 0.002）相关，但 16%报告 SI 的人抑郁仅为“轻度”。在 12 个月时，9.6%（95%CI = 0.07, 0.13）报告有 SI，与基线相比无显著差异。在 12 个月内 SI 结果最差的个体失业、残疾、焦虑、抑郁、疲劳、如厕困难和痉挛更多，但在回归分析中，没有任何一个变量与 SI 变化有单独的关联。
SI 很复杂，但本研究仅通过单一问题来衡量。
在 MS 诊断后不久，SI 相对常见，不仅在焦虑和抑郁存在时如此，而且在只有轻度抑郁的个体中也是如此。对 SI 进行筛查很重要，这可以使临床医生能够为新诊断的个体提供支持。
