MS patients face higher risk of death by suicide: Analysis
Nearly a quarter of patients report having suicidal thoughts
- Multiple sclerosis patients face a 49% higher suicide risk than the general population.
- Nearly one-quarter of MS patients experience suicidal thoughts, with 3.4% attempting suicide.
- Integrating mental health care, routine risk assessments, and multidisciplinary interventions are crucial.
People with multiple sclerosis (MS) have a higher risk of dying by suicide than the general population, according to a meta-analysis of published studies.
Nearly one-quarter of participants in the studies had thoughts about suicide (suicidal ideation). Across the studies, 0.5% of participants died by suicide, which represented 2.1% of all deaths observed in people with MS. Proportionately, this translated to about a 49% higher rate of death by suicide than in control populations without MS.
“These findings emphasize the need for targeted mental health strategies and integration of psychological care into routine MS management,” the researchers wrote.
The study, “Suicide Ideation, Attempts, and Mortality in Multiple Sclerosis: A Systematic Review and Meta-Analysis,” was published in the journal Brain and Behavior.
MS symptoms can vary, and include fatigue, difficulty walking, and pain. In addition, mental health problems are common in MS. Living with the disease “means facing significant obstacles in managing the unpredictable nature of this lifelong condition,” the researchers wrote.
64 studies, 19 countries
The team of researchers in Iran conducted a systematic review and meta-analysis, grouping data from multiple published studies to assess the potential association between MS and suicide-related outcomes.
They examined data from 64 studies across 19 countries, predominantly from Europe and North America, involving more than 200,000 people with MS. The studies were published from 1991 to 2024, and 18 also included healthy controls.
Across the studies, 22.6% of participants with MS reported suicide ideation. Rates were slightly higher in Asian populations and in those younger than 45, but statistical analyses found no significant differences among different geographical locations and age groups.
Studies that used different tools to capture suicidal ideation data differed in their reports, however. Rates of suicidal ideation were significantly higher in studies that used suicide ideation-specific instruments (31.7%) compared with those that used more general screening tools (16.3%).
This “suggests that future research should prioritize the use of validated, suicidality-focused instruments for accurate detection and monitoring,” the team wrote.
About 3.4% of participants attempted suicide, although the numbers varied significantly depending on study location. The prevalence of suicide attempts reported in studies conducted in Europe was 1.8%, while studies in North America reported a 4% prevalence. Only one non-Western study, from Iran, reported suicide attempts; it had the highest prevalence, 8.4%.
Cultural factors and variations in healthcare systems may account for the geographical differences, the researchers said.
Together, the results highlight that suicide is a substantial concern among people with MS, the team said. Targeted mental health interventions might help reduce suicidal ideation, attempts, and deaths, the researchers said. They suggested integrating mental health services into routine MS care.
“Multidisciplinary collaboration among neurologists, psychiatrists, and primary care providers is essential to facilitate routine suicide risk assessments and timely interventions, including evidence-based psychotherapies and pharmacologic treatments,” the researchers wrote.
Because the meta-analysis relied on published data, the study designs and participants varied significantly, potentially limiting the results. The team also highlighted the need for more studies in Asia, South America, and Africa.
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