title: Prevalence and risk factors for suicidal ideation in a multiple sclerosis population.
abstract: OBJECTIVE
  To estimate the prevalence, incidence and determinants of suicidal ideation in the multiple sclerosis (MS) population.
  
  
  METHODS
  A sample of 188 subjects were randomly selected from a community-based MS clinic registry and participated in as many as 13 interviews over 6 months. Thoughts of "being better off dead" or of "harming oneself" were assessed using item 9 on the Patient Health Questionnaire, Brief (PHQ-9).
  
  
  RESULTS
  At baseline, the 2-week period prevalence of suicidal ideation was 8.3%. Over the course of 6 months, 22.1% of respondents reported having such thoughts at least once. Survival analysis incorporating baseline PHQ-8 scores as a covariate confirmed that being age 65 and over (HR=4.3, 95% CI 1.7-11.3) and having lower quartile self-efficacy ratings (HR=3.5, 95% CI 1.5-8.2) predicted suicidal ideation. Lower levels of task-oriented coping (treated as a continuous variable) also predicted suicidal ideation after adjustment for depressive symptoms (p=0.015), as did self-reported bladder or bowel symptoms (HR=2.6, 95% CI 1.1-6.0) and difficulties with speaking and swallowing (HR=2.9, 95% CI 1.3-6.8). Associations with MS symptoms were not confounded by depressive symptoms.
  
  
  CONCLUSIONS
  This study identified several potentially modifiable factors that may be useful for preventing suicide in people with MS.
authors.affiliation: Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Canada.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Viner
authors.affiliation: Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Canada; Department of Psychiatry and Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada. Electronic address: patten@ucalgary.ca.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Patten
authors.affiliation: Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Canada.
authors.forename: Sandra
authors.initials: S
authors.lastname: Berzins
authors.affiliation: Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Canada; Department of Psychiatry and Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada.
authors.forename: Andrew G M
authors.initials: AG
authors.lastname: Bulloch
authors.affiliation: Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, Canada.
authors.forename: Kirsten M
authors.initials: KM
authors.lastname: Fiest
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000523:psychology*; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Coping; Depression; Longitudinal studies; Multiple sclerosis; Suicidal ideation