Suicide risk in multiple sclerosis: a systematic review of current literature
Abstract
Background Studies have shown that suicidal ideation is often revealed among patients suffering from Multiple Sclerosis (MS). Mental health assessment of physically ill patients should form part of routine clinical evaluation, particularly in chronic illness.Objective The aim of the present paper was to investigate whether there was a relationship between MS and suicidal behavior.Methods A systematic review of the literature was conducted to determine the potential association between MS and suicidal behavior. A total of 12 articles from peer-reviewed journals were considered and selected for this review.Results Most studies have documented a higher suicide rate in patients with MS compared to the general population, and suicide was associated with several risk factors: Depression severity, social isolation, younger age, progressive disease subtype, lower income, earlier disease course, higher levels of physical disability, and not driving.Conclusions Clinicians should be aware of the fact that suicidality may occur with higher frequency in MS patients, the available data suggest that the risk of self-harm is higher than expected in MS patients.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Social isolation is associated with suicidal ideation amongst individuals with multiple sclerosis.
“social isolation was associated with suicidal ideation amongst individuals with multiple sclerosis 54”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as [54]
Cites
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164 · see citing works
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · BMJ · doi:10.1136/bmj.b2700 · Cited by 17,648 · see citing works
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Italian Journal of Public Health · doi:10.2427/5768 · Cited by 3,374 · see citing works
Gupta, M., & Gupta, A. K. (1998) · British Journal of Dermatology · doi:10.1046/j.1365-2133.1998.02511.x · Cited by 927 · see citing works
The International Handbook of Suicide and Attempted Suicide
(2000) · doi:10.1002/9780470698976 · Cited by 819 · see citing works
Depression in multiple sclerosis: a review
Siegert, R. J. (2005) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.2004.054635 · Cited by 718 · see citing works
The international handbook of suicide and attempted suicide
Rosenman, S. J. (2001) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.2001.0949k.x · Cited by 431 · see citing works
Cause of death in patients attending multiple sclerosis clinics
Sadovnick, A. D., Eisen, K., Ebers, G. C., & Paty, D. W. (1991) · Neurology · doi:10.1212/wnl.41.8.1193 · Cited by 401 · see citing works
Quality of Life Among Persons with Multiple Sclerosis and their Caregivers
Aronson, K. J. (1997) · Neurology · doi:10.1212/wnl.48.1.74 · Cited by 342 · see citing works
An examination of suicidal intent in patients with multiple sclerosis
Feinstein, A. (2002) · Neurology · doi:10.1212/wnl.59.5.674 · Cited by 326 · see citing works
Trends in survival and cause of death in Danish patients with multiple sclerosis
Brønnum‐Hansen, H. (2004) · Brain · doi:10.1093/brain/awh104 · Cited by 281 · see citing works
Depression in multiple sclerosis.
Minden, S., Orav, J., & Reich, P. (1987) · General Hospital Psychiatry · doi:10.1016/0163-8343(87)90052-1 · Cited by 267 · see citing works
Suicide and multiple sclerosis: an epidemiological investigation.
Stenager, E., Stenager, E., Koch–Henriksen, N., Brønnum‐Hansen, H., Hyllested, K., Jensen, K., & Bille‐Brahe, U. (1992) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.55.7.542 · Cited by 218 · see citing works
Psychiatric Aspects of Suicidal Behaviour: Depression
Lönnqvist, J. K. (2000) · doi:10.1002/9780470698976.ch7 · Cited by 160 · see citing works
Suicide among Danes with multiple sclerosis
Brønnum‐Hansen, H. (2005) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2004.056747 · Cited by 154 · see citing works
Suicide attempts in the United States: the role of physical illness
Goodwin, R. D., Marušič†, A., & Hoven, C. W. (2003) · Social Science & Medicine · doi:10.1016/s0277-9536(02)00174-0 · Cited by 143 · see citing works
Koch–Henriksen, N., Brønnum‐Hansen, H., & Stenager, E. (1998) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.65.1.56 · Cited by 133 · see citing works
Fragoso, Y. D., Frota, E. R. C., Lopes, J. S., Noal, J. S., Giacomo, M. C., Gomes, S., Gonçalves, M. V. M., da Gama, P. D., & Finkelsztejn, A. (2010) · Clinical Neuropharmacology · doi:10.1097/wnf.0b013e3181f8d513 · Cited by 116 · see citing works
Elevated Suicide Risk among Patients with Multiple Sclerosis in Sweden
Fredrikson, S., Cheng, Q., Jiang, G., & Wasserman, D. (2003) · Neuroepidemiology · doi:10.1159/000068746 · Cited by 107 · see citing works
Suicidal ideation in multiple sclerosis.
Turner, A., Williams, R. M., Bowen, J., Kivlahan, D., & Haselkorn, J. (2006) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2006.04.021 · Cited by 106 · see citing works
Kahana, E., Leibowitz, U., & Alter, M. (1971) · Neurology · doi:10.1212/wnl.21.12.1179 · Cited by 103 · see citing works
Lalmohamed, A., Bazelier, M. T., van Staa, T. P., Uitdehaag, B. M. J., Leufkens, H. G. M., de Boer, A., & de Vries, F. (2012) · European Journal of Neurology · doi:10.1111/j.1468-1331.2012.03668.x · Cited by 99 · see citing works
Prevalence and correlates of suicidal ideation in SLE inpatients: Chinese experience
Xie, L., Chen, P.-L., Pan, H., Tao, J., Li, X.-P., Zhang, Y., Zhai, Y., & Ye, D. (2011) · Rheumatology International · doi:10.1007/s00296-011-2043-3 · Cited by 85 · see citing works
Interferon β1a and depression in secondary progressive MS: Data from the SPECTRIMS Trial
Patten, S. B., & Metz, L. M. (2002) · Neurology · doi:10.1212/wnl.59.5.744 · Cited by 82 · see citing works
Prevalence and correlates of depression among veterans with multiple sclerosis
Williams, R. M., Turner, A., Hatzakis, M., Bowen, J., Rodriquez, A., & Haselkorn, J. (2005) · Neurology · doi:10.1212/01.wnl.0000148480.31424.2a · Cited by 80 · see citing works
Suicide Screening in a Primary Care Setting at a Veterans Affairs Medical Center
Lish, J. D., Zimmerman, M. A., Farber, N. J., Lush, D. T., Kuzma, M. A., & Plescia, G. (1996) · Psychosomatics · doi:10.1016/s0033-3182(96)71528-1 · Cited by 60 · see citing works
Physical Illness and Suicidal Behaviour
Stenager, E. N., & Stenager, E. (2000) · doi:10.1002/9780470698976.ch22 · Cited by 59 · see citing works
Suicidal ideation among outpatients at general neurology clinics: prospective study
Carson, A. J. (2000) · BMJ · doi:10.1136/bmj.320.7245.1311 · Cited by 56 · see citing works
Suicide, assisted suicide, and medical illness.
Hendin, H. (1999) · PubMed · Cited by 52 · see citing works
Hospital-based Psychiatric Service Utilization and Morbidity in Multiple Sclerosis
Fisk, J. D., Morehouse, S. A., Brown, M. G., Skedgel, C. D., & Murray, T. J. (1998) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/s0317167100034065 · Cited by 48 · see citing works
Identifying suicide potential in primary care
Lin, E. H. B., Korff, M. V., & Wagner, E. H. (1989) · Journal of General Internal Medicine · doi:10.1007/bf02596482 · Cited by 44 · see citing works
The Natural History of Multiple Sclerosis
Goodkin, D. E. (1992) · Clinical medicine and the nervous system · doi:10.1007/978-1-4471-3184-7_2 · Cited by 40 · see citing works
Suicidal Tendency and Multiple Sclerosis
Long, D. D., & Miller, B. J. (1991) · Health & Social Work · doi:10.1093/hsw/16.2.104 · Cited by 35 · see citing works
Multiple Sclerosis: An Overview
(2015) · BENTHAM SCIENCE PUBLISHERS eBooks · doi:10.2174/9781608059928115010014 · Cited by 32 · see citing works
Hopelessness Ratings in Relapsing-Remitting and Secondary Progressive Multiple Sclerosis
Patten, S. B., & Metz, L. M. (2002) · The International Journal of Psychiatry in Medicine · doi:10.2190/2g2n-we19-nm47-jny8 · Cited by 30 · see citing works
Suicide attempts in multiple sclerosis
Stenager, E. N., Jensen, B. F., Stenager, M., et al. (2011) · Multiple Sclerosis Journal · doi:10.1177/1352458511401942 · Cited by 24 · see citing works
Psychiatric manifestations of autoimmune disorders
Weiss, D., Dyrud, J., House, R., & Beresford, T. (2005) · Current Treatment Options in Neurology · doi:10.1007/s11940-005-0033-z · Cited by 21 · see citing works
Aspectos históricos de la esclerosis múltiple
Moreira, M. A., Tilbery, C. P., Lana–Peixoto, M. A., et al. (2002) · Revista de Neurología · doi:10.33588/rn.3404.2001313 · Cited by 18 · see citing works
Depression in multiple sclerosis
Iwasaki, Y., Iwamoto, K., IGARASHI, O., Kiyozuka, T., Aoyagi, J., Hirano, K., Sato, R., Kawase, Y., Iwasa, Y., & Ikeda, K. (2005) · Acta Neurologica Scandinavica · doi:10.1111/j.1600-0404.2005.00390.x · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Leigh-Hunt, N., Bagguley, D., Bash, K., Turner, V., Turnbull, S., Valtorta, N., & Caan, W. (2017) · Public Health · doi:10.1016/j.puhe.2017.07.035 · Cited by 2,158 · see citing works
Epidemiology of suicide and the psychiatric perspective
Bachmann, S. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15071425 · Cited by 1,377 · see citing works
Erlangsen, A., Stenager, E., & Conwell, Y. (2015) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-015-1051-0 · Cited by 174 · see citing works
Bahrani, S., Zargar, F., Yousefipour, G., & Akbari, H. (2017) · Iranian Red Crescent Medical Journal · doi:10.5812/ircmj.44566 · Cited by 36 · see citing works
- Authors
- Pompili, M., Forte, A., Palermo, M., Stefani, H., Lamis, D. A., Serafini, G., Amore, M., & Girardi, P.
- Affiliations
- Harvard University (US)
- Azienda Ospedaliera Sant'Andrea (IT)
- Emory University (US)
- University of Genoa (IT)
- Corresponding author
- Pompili, Maurizio
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 73
- Issue
- 6
- Pages
- 411-417
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W2023102395
- Cited by
- 163
- References
- 39
- Citations by year
- 2026: 7 · 2025: 3 · 2024: 11 · 2023: 12 · 2022: 9 · 2021: 9 · 2020: 13 · 2019: 11 · 2018: 16 · 2017: 15 · 2016: 15 · 2015: 17 · 2014: 17 · 2013: 7
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- multiple sclerosis, suicide risk, suicidal ideation, depression, social isolation, physical disability, socioeconomic factors, mental health assessment, chronic disease
- MeSH terms
- Adult, Depression, Female, Humans, Male, Multiple Sclerosis, Risk Factors, Severity of Illness Index, Social Isolation, Suicide, Suicidal Ideation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
