CoChat
Sign Up
Cited by 100Suicide and Self-Harm StudiesAmyotrophic Lateral Sclerosis ResearchPalliative Care and End-of-Life Issues

Suicide among patients with amyotrophic lateral sclerosis

Fang, Fang, Valdimarsdóttir, Unnur, Fürst, Carl Johan, Hultman, Christina, Fall, Katja, Sparén, Pär, Ye, Weimin·2008·Brain
DOI 10.1093/brain/awn161
Open this paper in CoChat — free account

Abstract

Studies on the suicide risk among patients with amyotrophic lateral sclerosis (ALS) in countries without legalized euthanasia or assisted suicide are important additions to data on the wish to die of these patients. We conducted a population-based cohort study in Sweden between 1965 and 2004, which comprised of 6,642 patients with incident ALS identified from the Swedish Inpatient Register. We calculated the standardized mortality ratios (SMRs) of suicide among the patients using the suicide rates of the general Swedish population as a reference. In total, 21 patients committed suicide during follow-up, compared to the predicted 3.6 suicides. Thus, we noted an almost 6-fold increased risk for suicide among ALS patients [SMR 5.8, 95% confidence interval (CI) 3.6-8.8]. Patients who committed suicide were, on average, around 7 years younger at the time of their first period of hospitalization than patients who did not commit suicide. The highest relative risk for suicide was observed within the first year after the patient's first period of hospitalization (SMR 11.2, 95% CI 5.8-19.6). After that, the relative risks decreased with time after hospitalization (P-value for trend = 0.006), but remained elevated 3 years later. The relative risks of suicide among ALS patients did not show a clear trend over time in contrast to the decreasing trend of relative risks for suicide among patients with cancer during the same period. Patients with ALS are at excess risk of suicide in Sweden and the relative risk is higher during the earlier stage of the disease.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1093/brain/awn161

Cites

21 of 21 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

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?

  • Poor quality of life and psychological distress are associated with negative outcomes, including shorter survival time and increased risk of suicide, in people with motor neuron disease.

    “poor quality of life and psychological distress are associated with negative outcomes, including shorter survival time and increased risk of suicide. 4-6”

    From Acceptance and Commitment Therapy plus usual care for improving quality of life in people with motor neuron disease (COMMEND): a multicentre, parallel, randomised controlled trial in the UK (2024) · cites this paper as [4]

    The Discussion reports elevated suicide risk among people with ALS and discusses psychological distress, but it does not establish that distress or poor quality of life predicts suicide. The Introduction describes the disease’s usual course; it does not link poor quality of life or distress to shorter survival. No page number is available in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Shorter survival times, poorer quality of life and increased risks of suicide and mortality have been reported in those experiencing psychological distress.

    “Although shorter survival times, poorer quality of life and increased risks of suicide and mortality have been reported in those experiencing psychological distress [8–12]”

    From A randomised controlled trial of acceptance and commitment therapy plus usual care compared to usual care alone for improving psychological health in people with motor neuron disease (COMMEND): study protocol. (2022) · cites this paper as [8]

    The Results report that patients with ALS had about six times the suicide risk of the general population, and the Discussion links this excess risk to psychological suffering. The paper does not establish that psychological distress itself predicts suicide, nor does it report shorter survival, poorer quality of life, or increased overall mortality among distressed people. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Amyotrophic lateral sclerosis has an estimated sixfold increased risk for suicide and multiple sclerosis a two-fold risk.

    “amyotrophic lateral sclerosis has an estimated sixfold increased risk (Fang, Valdimarsdóttir, Fürst, Hultman, Fall, Sparén, et al., 2008) and multiple sclerosis a two-fold risk (Harris & Barraclough, 1997)”

    From The interpersonal theory of suicide. (2010) · cites this paper as Fang, Valdimarsdóttir, Fürst, Hultman, Fall, Sparén, et al., 2008

  • People with motor neuron disease have greater risks of suicide than the general population.

    “This can have a negative effect on emotional wellbeing and self-esteem, as indicated by high prevalence rates of depression and anxiety (44 and 30%, respectively (3,4)) and greater risks of suicide in pwMND than in the general population (5,6).”

    From Needs and preferences for psychological interventions of people with motor neuron disease (2019) · cites this paper as [6]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Bjorkenstam C, Edberg A, Ayoubi S, Rosen M. Are cancer patients at higher suicide risk than the general population? Scand J Public Health 2005; 33: 208-14.

Cited by

Sorted by citations

Related

Authors
Fang, F., Valdimarsdóttir, U., Fürst, C. J., Hultman, C., Fall, K., Sparén, P., & Ye, W.
Affiliations
  • Karolinska Institutet (SE)
  • University of Iceland (IS)
  • Stockholms Sjukhem Palliative Care Unit, Stockholm
  • Uppsala University (SE)
Corresponding author
Fang, Fang
ORCID
Venue
Brain
Publisher
Oxford University Press (OUP)
Published
2008-07-22
Volume
131
Issue
10
Pages
2729-2733
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
DOI
10.1093/brain/awn161
OpenAlex
W2105863226
Cited by
100
References
21
Citations by year
2026: 4 · 2025: 2 · 2024: 6 · 2023: 10 · 2022: 10 · 2021: 11 · 2020: 7 · 2019: 8 · 2018: 4 · 2017: 5 · 2016: 2 · 2015: 6 · 2014: 4 · 2013: 7 · 2012: 4
FWCI
3.70
Type
journal article
Language
en
Open access
closed
Locations
  • Brain (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Keywords
amyotrophic lateral sclerosis, suicide, suicide risk, standardized mortality ratio, desire for death, disease stage, end-of-life care
MeSH terms
Amyotrophic Lateral Sclerosis, Depression, Hospitalization, Humans, Registries, Risk, Suicide, Sweden, Prevalence, Risk Assessment

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