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Suicide among patients with amyotrophic lateral sclerosis
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; Centre of Public Health Sciences,University of Iceland, Reykjavik, Iceland.
Stockholms Sjukhem, Palliative Care Unit, Stockholm.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; Department of Neuroscience, Psychiatry, Ulleråker,Uppsala University,Uppsala.
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2008 (English)In: Brain, ISSN 0006-8950, E-ISSN 1460-2156, Vol. 131, no 10, p. 2729-33Article in journal (Refereed) Published
Abstract [en]

Studies on the suicide risk among patients with amyotrophic lateral sclerosis (ALS) in countries without legalized euthanasia or assisted suicide are important additions to data on the wish to die of these patients. We conducted a population-based cohort study in Sweden between 1965 and 2004, which comprised of 6,642 patients with incident ALS identified from the Swedish Inpatient Register. We calculated the standardized mortality ratios (SMRs) of suicide among the patients using the suicide rates of the general Swedish population as a reference. In total, 21 patients committed suicide during follow-up, compared to the predicted 3.6 suicides. Thus, we noted an almost 6-fold increased risk for suicide among ALS patients [SMR 5.8, 95% confidence interval (CI) 3.6-8.8]. Patients who committed suicide were, on average, around 7 years younger at the time of their first period of hospitalization than patients who did not commit suicide. The highest relative risk for suicide was observed within the first year after the patient's first period of hospitalization (SMR 11.2, 95% CI 5.8-19.6). After that, the relative risks decreased with time after hospitalization (P-value for trend = 0.006), but remained elevated 3 years later. The relative risks of suicide among ALS patients did not show a clear trend over time in contrast to the decreasing trend of relative risks for suicide among patients with cancer during the same period. Patients with ALS are at excess risk of suicide in Sweden and the relative risk is higher during the earlier stage of the disease.

Place, publisher, year, edition, pages
Oxford, United Kingdom: Oxford University Press, 2008. Vol. 131, no 10, p. 2729-33
Keywords [en]
Amyotrophic lateral sclerosis, suicide, cohort study, relative risk
National Category
Medical and Health Sciences Neurosciences
Identifiers
URN: urn:nbn:se:oru:diva-41462DOI: 10.1093/brain/awn161ISI: 000260381300019PubMedID: 18669498Scopus ID: 2-s2.0-54949142240OAI: oai:DiVA.org:oru-41462DiVA, id: diva2:811694
Available from: 2015-05-12 Created: 2015-01-14 Last updated: 2018-01-11Bibliographically approved

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