title: Suicidal thinking in multiple sclerosis.
abstract: OBJECTIVE
  Studies demonstrate that suicidal ideation (SI) is greater in persons with multiple sclerosis (MS) than in the general population. SI may offer some MS patients a mechanism for feeling in control of their lives, in the face of a daunting, unpredictable disease. In this study, we determined what specific mental constructs or perceptual themes occur for MS patients experiencing SI, while also examining the construct of 'control' as a central theme.
  
  
  METHODS
  Individual interviews (N = 16) were audiotaped, transcribed and qualitatively analysed by two independent raters to test for key themes in MS patients reporting SI.
  
  
  RESULTS
  In relation to SI, eight key themes were identified by both raters as having been expressed in interviews: perceived loss of control, increased family tension, loneliness, hopelessness and frustration, physical and psychological impact of MS, loss of perceived masculinity or femininity, regaining control and failure to achieve desired or expected role functioning. We created a model to explain the emergence of these themes as they contribute to SI among patients with MS. All participants indicated that perceived loss of control elicited thoughts of suicide.
  
  
  CONCLUSIONS
  Perceived loss of control appears to be a major disease related burden associated with SI in MS patients.
authors.affiliation: Ferkauf Graduate School of Psychology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
authors.forename: Aviva
authors.initials: A
authors.lastname: Gaskill
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Foley
authors.forename: Julie
authors.initials: J
authors.lastname: Kolzet
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Picone
mesh_terms: D000328:Adult; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012307:Risk Factors; D059020:Suicidal Ideation