Objective:

To determine rates of depression and feelings of suicidality in youth with pediatric-onset multiple sclerosis (POMS).

Background:

Depression has been documented in 30% of POMS patients when evaluated using formal neuropsychological testing. Detection of depressed mood and suicidality using screening tools in regular clinical care would prioritize selection of patients at greatest needs for further testing and intervention.

Design/Methods:

Pilot study in a single POMS program utilizing the Patient Health Questionnaire (PHQ-9), which assesses the symptom frequency of 9 items during the immediately preceding 2 weeks, with scores of 5–9 indicating mild depression; 10–14: moderate depression; 15–19: moderately severe depression; and ≥ 20-27: severe depression. Suicidality was assessed by a single question asking, “Have you had] thoughts that you would be better off dead or of hurting yourself in some way”. Patients endorsing suicidality were evaluated by their physician or a trained social worker to assess the patient’s safety, utilizing the Columbia Suicide Severity Rating Scale when applicable.

Results:

Eighteen of 54 (33.33%) POMS patients reported experiencing at least moderate depression (9 with moderate depression, 7 with moderately severe depression, and 2 with severe depression). Nine patients endorsed suicidal ideation. Of those experiencing at least moderate depression, 38.89% of patients endorsed suicidal thoughts; one patient required emergency crisis intervention in the emergency room.

Conclusions:

Screening for depression and suicidal ideation in POMS clinic identified that 33.33% experienced depressive symptoms- very similar to rates identified using semi-structured diagnostic interview and lengthier parent-report questionnaires. Suicidal thoughts were endorsed by almost 40% of those with depressed mood- highlighting the critical importance of specifically asking such questions. Increased suicidality in youth has been identified as a national health emergency.