title: An excessive risk of suicide may no longer be a reality for multiple sclerosis patients.
abstract: Few recent studies have shown that there is no longer an increased risk of suicide in patients affected with multiple sclerosis (MS).
  
  
  
  To describe suicide cases within a large French MS cohort and assess whether MS patients are at a higher risk of suicide compared with the general population.
  
  
  
  Data derives from a study on long-term mortality of 27,603 prevalent cases from 15 MS specialist centres. Of 1,569 deceased MS patients (5.7%) on 1 January 2010, 47 were suicides.
  
  
  
  The mean time between MS clinical onset and death was 13.5 years (standard deviation (SD): 9.3 years; none within the first 3 years) and was significantly shorter than for MS patients who had died from other causes (mean = 21.4 (SD = 11.6), p < 0.0001). Age at death was also lower (46.3 vs 56.7). The standardized mortality rates were around 1 in several sensitivity analyses, reflecting no excess mortality in MS compared with general population.
  
  
  
  Our findings indicate that an excess suicide risk may no longer be true for MS patients and highlight the changing profile of cases, occurring later in the disease course. Further studies in population-based registries are needed to confirm and explain these potential changes (e.g. treatments' impact?).
authors.affiliation: Ecole des Hautes Etudes en Santé Publique (EHESP), Département METIS, Rennes Cedex, France.
authors.forename: Shoshannah
authors.initials: S
authors.lastname: Kalson-Ray
authors.affiliation: Service de Neurologie and CIC-P 1414, CHU de Rennes, Rennes Cedex, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Edan
authors.affiliation: Ecole des Hautes Etudes en Santé Publique (EHESP), Département METIS, Rennes Cedex, France; CIC-P 1414 CHU de Rennes, Rennes Cedex, France; and EA 7449 REPERES, Université de Rennes 1/EHESP, Rennes Cedex, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Leray
mesh_terms: D000328:Adult; D002423:Cause of Death; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000401:mortality*; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013405:Suicide / Q000706:statistics & numerical data*
keywords: Multiple sclerosis; mortality; risk factors; standardized mortality ratio; suicide