Suicide among Danes with multiple sclerosis

Brønnum-Hansen, Henrik; Stenager, Egon; Stenager, Elsebeth; Koch‐Henriksen, Nils

doi:10.1136/jnnp.2004.056747

Cited by 133 publications

(114 citation statements)

References 19 publications

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“…21 Risk of suicide, probably related with a poor QOL, among persons with MS is about three times higher during the first years after diagnosis as expected in the general population. 22 Furthermore, among patients diagnosed with MS more than 20 years ago, the suicide risk is almost twice as high as expected, probably because these patients experience the most serious consequences of the disease. 22 In our previous study, 23 in which we examined the relative impact of MS-related disabilities on QOL, using the Multiple Sclerosis Impact Profile (MSIP) we found that impairment in mental functioning was the most important predictor for QOL.…”

Section: Introductionmentioning

confidence: 99%

Change in disability profile and quality of life in multiple sclerosis patients: a five-year longitudinal study using the Multiple Sclerosis Impact Profile (MSIP)

et al. 2011

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Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Wynia, K., van Wijlen, A. T., Middel, B., Reijneveld, S. A., & Meilof, J. F. (2012). Change in disability profile and quality of life in multiple sclerosis patients: a five-year longitudinal study using the Multiple Sclerosis Impact Profile (MSIP). Multiple sclerosis journal, 18(5), 654-661. https://doi.org/10.1177/1352458511423935 Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons).Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. MULTIPLE SCLEROSIS MSJ JOURNAL IntroductionMultiple Sclerosis (MS) is a chronic neurological disease of the central nervous system and is potentially the most common cause of neurological disability in young adults. 1 The disease course is characterized by either acute periods of deterioration or relapses (about 85% of patients initially), or gradual progressive deterioration of neurological functioning, or combinations of the two.Understanding the course of chronic diseases is a recurrent objective in research. Natural history studies, for example, are follow-up studies that provide the strongest evidence. These studies thoroughly examine the course of the disease among a large number of patients for a period of about 30-40 years. Natural history studies in MS have Objectives: To examine the course of a broad spectrum of MS-related disabilities and quality of life (QOL) in relation to disease severity, and responsiveness of the Multiple Sclerosis Impact Profile (MSIP). Methods: The mortality rate was calculated after checking the national population register for vital status of the initial cohort. We performed a longitudinal study among 245 patients with MS attending the Groningen MS Center in the Netherlands. We assessed these patients in 2004 and 2009 using a postal survey including the MSIP to evaluate disabilities, the World Health Organization Quality of Life-Abbreviation version (WHOQOL-BREF) to evaluate QOL, and the ambulation question of the Expanded Disability Status Scale (EDSS) to evaluate disease severity. Responsiveness of the MSIP was estimated using standardized response mean (SRM). Results: Increase of disability in the MSIP disability domains and loss of QOL were most prevalent and pronounced in patients with EDSS 0 to < 4.5 in 2004. MSIP and QOL scores were remarkably stable in the higher disease severity groups. Mortality rates were highest (24%) in patients with EDSS ≥ 7 to < 10 in 2004. SRM indices for the MSIP ra...

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Section: Introductionmentioning

confidence: 99%

Change in disability profile and quality of life in multiple sclerosis patients: a five-year longitudinal study using the Multiple Sclerosis Impact Profile (MSIP)

et al. 2011

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“…34 However, adequately powered population-based register studies show more uniform results with an approximately doubled suicide risk compared to the general population. [35][36][37] The relative risk is highest within 5 years after diagnosis, with over 50% of suicides occurring in this interval.…”

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Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions

Brenner

Piehl

2016

Acta Neurol Scand

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Multiple sclerosis (MS) is a neuroinflammatory condition with a prominent progressive neurodegenerative facet that typically affects young-or middle-aged adults. Although physical disabilities have been in the foreground by being easier to assess, there is an increasing interest in mental disabilities and psychiatric co-morbidities, which have a disproportionally high impact on important outcome measures such as quality of life and occupational disability. In particular, cognitive impairment, depression and mental fatigue, which mutually interact with each other, seem to be of importance in this context. In recent decades, major efforts have been invested in developing more effective disease modulatory treatments. This has resulted in novel therapeutic options and awareness of the importance of early intervention. In comparison, good quality and adequately powered studies on symptomatic treatments of fatigue and psychiatric co-morbidities in MS are rare, and awareness of treatment options is much lower. We here review the existing evidence base for symptomatic treatment of fatigue and depression in MS patients. With regard to fatigue, off-label prescription of alertness improving drugs is common, in spite of all but absent evidence of efficacy. In contrast, a number of smaller studies suggest that physical exercise and fatigue management courses may have some clinical benefit. Very few studies have addressed the efficacy of antidepressants and non-pharmaceutical interventions specifically in MS patients. Therefore, treatment guidelines largely rely on data from non-MS populations. In the future, there is a strong motive to direct additional resources to the study of these important aspects of MS. K E Y W O R D Scognitive symptoms, depression, fatigue, multiple sclerosis, treatment

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“…1,2 Undetected and untreated mental illness may worsen functioning 3 and quality of life, [4][5][6][7][8] decrease treatment adherence, 9 and increase risk of suicide. [10][11][12][13][14][15][16] Improved detection, diagnosis, and treatment practices in medical settings where individuals with emotional disorders are often first seen would help ameliorate these negative outcomes. This guideline reviews the evidence and makes recommendations for identifying, diagnosing, and treating psychiatric disorders in individuals with MS.…”

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confidence: 99%

“…31 Suicide may be at least twice as common. [10][11][12][13][14][15][16] Prevalence estimates for pseudobulbar affect (PBA) range from 6.5% to 46.2% [32][33][34] ; the prevalence of euphoria is unknown. 35 Depressive and manic/hypomanic symptoms may occur with high-dose corticosteroids, 36 but the association between depressed mood and disease-modifying therapies is unclear.…”

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confidence: 99%

Evidence-based guideline: Assessment and management of psychiatric disorders in individuals with MS

et al. 2014

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Suicide among Danes with multiple sclerosis

Cited by 133 publications

References 19 publications

Change in disability profile and quality of life in multiple sclerosis patients: a five-year longitudinal study using the Multiple Sclerosis Impact Profile (MSIP)

Change in disability profile and quality of life in multiple sclerosis patients: a five-year longitudinal study using the Multiple Sclerosis Impact Profile (MSIP)

Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions

Evidence-based guideline: Assessment and management of psychiatric disorders in individuals with MS

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