Suicide and Patients With Neurologic Diseases

Stenager, Elsebeth

doi:10.1001/archneur.1992.00530360098025

Cited by 88 publications

(59 citation statements)

References 46 publications

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“…The combination may ultimately lead to suicide. Investigators in Denmark showed that the cumulative lifetime risk for suicide from onset of MS was nearly twice that expected (standardized mortality ratio = 1.85) [99]. Suicide was the cause of 15 percent of deaths in a long-term followup study in Canada between 1972 and 1988 [100].…”

Section: Suicide and Multiple Sclerosismentioning

confidence: 97%

Depression and multiple sclerosis: Review of a lethal combination

Wallin¹,

Wilken

Turner

et al. 2006

JRRD

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Abstract-Depression is the most frequent psychiatric disorder in multiple sclerosis (MS) patients. The etiology of depression is multifactorial and likely associated with psychosocial stress, focal demyelinating lesions, and immune dysfunction. Proper diagnosis and severity assessment are critical prior to initiation of therapy. Patients with suicidal ideation should be referred for immediate psychiatric consultation and be closely monitored. While more therapeutic trials for depression in MS are needed, MS patients have been shown to respond to current antidepressant medications and psychotherapy. Unfortunately, patients with MS and major depression or suicidal thoughts are often underassessed and therefore not diagnosed. Unlike other aspects of MS, depression is treatable. Early intervention in depression can prevent declines in quality of life and even death from suicide. This article reviews the unique features, assessment, and treatment of depression in MS. MS care providers should vigilantly assess depression and suicide risk in their patients.

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Section: Suicide and Multiple Sclerosismentioning

confidence: 97%

Depression and multiple sclerosis: Review of a lethal combination

Wallin¹,

Wilken

Turner

et al. 2006

JRRD

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“…Delayed-onset suicidal plans have also been found to be associated with greater physical impairment [3]in contrast to acute-onset plans [2], suggesting that the etiology of these two types of suicidal plans may be different. In addition, an increased suicide risk has been found in patients suffering from other neurological disorders including multiple sclerosis and spinal cord lesions as well as in selected groups of patients with epilepsy [4]. In other neurological diseases, the suicide risk may be increased, but the results are uncertain due to the methodological problems in the study design [4].…”

Section: Introductionmentioning

confidence: 99%

Suicidal Ideas in Stroke Patients 3 and 15 Months after Stroke

et al. 2001

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Patients with stroke may have an increased risk of suicide. We sought to examine the frequency and clinical correlates of suicidal ideas 3 and 15 months after stroke. The study group comprised 286 of 486 consecutive patients aged 55–85 years who at 3 and 15 months after ischemic stroke completed a detailed medical, neurological and radiological stroke evaluation, structured measures of cognition (Mini Mental State Examination), emotion (Beck Depression Inventory, BDI), disability (Rankin scale), and assessment of dependent living. Suicidal ideas were present in 9.8% (n = 28) at 3 months’ follow-up and in 14.0% (n = 40) at 15 months’ follow-up. The patients with suicidal ideas were more depressed measured by BDI both at 3 (17.0 vs. 7.9, p < 0.001) and 15 months (20.5 vs. 8.5, p < 0.001) after stroke compared to the patients without suicidal ideas. Patients with suicidal ideas had more often a history of a stroke already before the index stroke (35 vs. 18.3%, p = 0.0154), right-sided stroke (60.0 vs. 41.9%, p = 0.0323), they were more disabled according to the Rankin scale (2.4 vs. 1.9; p = 0.0035) and more dependent in living (45.0 vs. 27.2%, p = 0.023) 15 months after stroke. An independent correlate of suicidal ideas 15 months after stroke was history of prior stroke (OR 2.4; 95% CI 1.14–4.97) in logistic regression analysis. The frequency of suicidal ideas increased with the time elapsed from stroke. Recurrent strokes, depressive symptoms, more disabling stroke and right-sided stroke correlated to suicidal ideas at 15 months after stroke. Early identification of these risk factors may lead to effective therapeutic intervention.

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“…1,2 Undetected and untreated mental illness may worsen functioning 3 and quality of life, [4][5][6][7][8] decrease treatment adherence, 9 and increase risk of suicide. [10][11][12][13][14][15][16] Improved detection, diagnosis, and treatment practices in medical settings where individuals with emotional disorders are often first seen would help ameliorate these negative outcomes. This guideline reviews the evidence and makes recommendations for identifying, diagnosing, and treating psychiatric disorders in individuals with MS.…”

mentioning

confidence: 99%

“…31 Suicide may be at least twice as common. [10][11][12][13][14][15][16] Prevalence estimates for pseudobulbar affect (PBA) range from 6.5% to 46.2% [32][33][34] ; the prevalence of euphoria is unknown. 35 Depressive and manic/hypomanic symptoms may occur with high-dose corticosteroids, 36 but the association between depressed mood and disease-modifying therapies is unclear.…”

mentioning

confidence: 99%