Abstract
Neurological diseases expose individuals to a higher risk of suicidal ideation and suicidal behavior, including completed suicides and suicide attempts. They also represent a paradigmatic arena to study the etiopathogenic mechanisms underlying suicidality because they are emblematic of the heterogeneity and complexity of mutual interrelationships characterizing this issue. On the one hand, neurological diseases imply strictly biological impairments that are postulated to be the basis of vulnerability to suicide or result in the need for treatments for which a suicidal risk has been hypothesized. On the other hand, they question some subjective experiences of neurological patients, up to near existential positions. Often, in fact, they are accompanied by severe hopelessness. The latter may originate in, particularly for the most severe neurological diseases, the absence of curative treatments, unpredictable disease progression that leads to acute relapses or chronicity, a decrease in autonomy or self-identity, progressive social isolation, a sense of becoming useless, and perception of feeling stigmatized. This may ultimately cause a slip into experiencing an absurd condition. At the confluence of neurobiology and hopelessness, frequent psychiatric comorbidities may play a primary role. To conclude, neurological patients require special attention from clinicians in form of openly verbalizing and exploring the suicidal thematic, inquiring about protective and risk factors, and promptly initiating both a psychopharmacological treatment and, where possible, psychological support.
Highlights
Neurological diseases expose a higher risk of Suicidal Ideation (SI) and Suicidal Behavior (SB), including Suicide Attempts (SA) and completed suicides [1,2,3]
A neurological disease occurring at a young age is often associated with a higher risk of suicide and this is one of the first factors to be considered in the suicidal risk assessment
This is the case for Multiple Sclerosis (MS), where SA risk has been reported to be at least 3 times greater than the general population and completed suicide risk 7.5-14 times greater
Summary
Neurological diseases expose a higher risk of Suicidal Ideation (SI) and Suicidal Behavior (SB), including Suicide Attempts (SA) and completed suicides [1,2,3].
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