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.

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全国多发性硬化症退伍军人样本中的自杀危险因素

目标 本研究检查了全国多发性硬化症 (MS) 退伍军人样本中自杀前一年的风险因素，以及自杀方式和死前接受心理健康服务 设计：病例对照研究。VA MS National Data Repository 中的个人与 National Death Index Plus 相关联，以获得死亡人数和具体死因。参与者是死于自杀的多发性硬化症退伍军人和随机选择的非自杀性多发性硬化症对照（每位参与者 5 人），他们在指标自杀时还活着。精神健康障碍和医学合并症是在自杀死亡前一年和对照组的同一时间段内确定的。设置退伍军人健康管理局 (VHA)。参与者 1999 年至 2011 年期间在美国退伍军人健康管理局 (VHA) 接受 MS 治疗的退伍军人。有 71 人死于相应的自杀，355 人是随机选择的对照组。干预 不适用。主要结果测量（S） 自杀。结果 调整后的多变量模型的结果表明以下因素与自杀风险增加有关：男性（OR = 3.60；95% CI = 1.35 - 9.42）抑郁症（OR = 1.82；95% CI = 1.03 - 3.23），和酒精使用障碍（OR = 3.10；95% CI = 1.38 - 6.96）。一半（50.7%）在自杀前一年有心理健康预约。主要的自杀方式是枪械 (62.0%) 结论：对 MS 患者的自杀风险进行常规评估是有必要的，特别是对于那些最近有抑郁症或酒精使用障碍病史的人。