Citation

Kellerman QD, Hartoonian N, Beier ML, Leipertz SL, Maynard C, Hostetter T, Haselkorn JK, Turner AP. Arch. Phys. Med. Rehabil. 2020; ePub(ePub): ePub.

Affiliation

VA Puget Sound Health Care System; VA Multiple Sclerosis Center of Excellence West; University of Washington Department of Rehabilitation Medicine. Electronic address: aaron.turner@va.gov.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.apmr.2020.03.013

PMID

32325161

Abstract

OBJECTIVE: This study examined risk factors in the year prior to suicide in a national sample of Veterans with multiple sclerosis (MS) as well as means of suicide and receipt of mental health services prior to death DESIGN: Case control Study. Individuals in the VA MS National Data Repository were linked to the National Death Index Plus to obtain deaths and specific causes of death. Participants were Veterans with MS who died by suicide and randomly selected non-suicide MS controls (5 per participant) who were alive at the time of the index suicide. Mental health disorders and medical comorbidities were identified in the year prior to death for suicides and during the identical time period for controls. SETTING: Veterans Health Administration (VHA). PARTICIPANTS: Veterans who received treatment for MS in the US Veterans Health Administration (VHA) between 1999 and 2011. There were 71 deaths by suicide corresponding and 355 randomly selected controls. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): Suicide.

RESULTS: Results from the adjusted multivariable model suggest the following factors were associated with an increased risk for suicide: male gender (OR = 3.60; 95% CI = 1.35 - 9.42) depression (OR = 1.82; 95% CI = 1.03 - 3.23), and alcohol use disorder (OR = 3.10; 95% CI = 1.38 - 6.96). One half (50.7%) had a mental health appointment in the year before suicide. Primary means of suicide was by firearm (62.0%) CONCLUSIONS: Routine assessment of suicide risk in individuals with MS is warranted, particularly for those with recent history of depression or alcohol use disorder.

Copyright © 2020. Published by Elsevier Inc.

Language: en

Keywords

Cause of Death; Depression; Multiple Sclerosis; Suicide; Veterans