The Role of Depression and Anxiety in Suicidal Ideation of People with Multiple Sclerosis: A Cross-sectional Study (PP-24)

Previous research indicates that people with multiple sclerosis (PwMS) are at an increased risk for suicidal ideation and attempts. Furthermore, suicidal ideation (SI) and its association with clinical characteristics and mood disorders have not been sufficiently investigated in PwMS. Hence, this study aimed to determine the frequency of suicidal thoughts and identify the independent variables contributing to SI among PwMS.
Methods
This cross-sectional study was conducted on 366 PwMS (312 relapsing-remitting MS (RRMS) and 54 progressive MS (PMS)) of the Multiple Sclerosis Clinic of Kashani Hospital, Isfahan, Iran, from June 2022 to May 2023. At baseline, demographic and clinical information was collected from PwMS. Additionally, the suicidal ideation, anxiety, and depression of PwMS were assessed using the German Beck Scale for Suicide Ideation, Beck Anxiety Inventory, and Beck Depression Inventory-II questionnaires, respectively. Linear and logistic regression analyses were used to assess the relationships between suicide, demographic and clinical variables, and mood disorders.
Results
Among the PwMS, 47 (12.8%) were identified as having a high to very high risk of SI, while 319 (87.2%) were classified as low risk. According to multivariable regression analyses, significant associations between the likelihood of SI and both depression (β = 0.18, p < 0.001) and anxiety (β = 0.09, p < 0.001) were found. However, neither the MS subtype (odds ratio (OR) = 2.82, p = 0.22) nor the Expanded Disability Status Scale (EDSS) (OR = 1.09, p = 0.69) exhibited a significant association with SI.
Conclusion
SI, a common precursor to suicide, is prevalent among PwMS. Moreover, anxiety and depression are predominant risk factors of SI in this population. Given the considerable frequency of SI and the lack of impact from MS subtype and disability on SI, it is highly recommended to evaluate SI, depression, and anxiety in the routine management of PwMS