Impact of Disability and Depression on Suicidality Among Patients with Relapsing-Remitting Multiple Sclerosis

Depression is a common comorbidity in multiple sclerosis (MS), significantly impacting quality of life and contributing to increased morbidity and mortality. In relapsing-remitting MS (RRMS), the pathogenesis of depression is multifactorial, involving neuroinflammatory processes, dysregulation of the hypothalamic–pituitary–adrenal axis, and the psychological stress associated with a chronic, unpredictable disease course. These mechanisms, alongside impaired adherence to disease-modifying therapies, further elevate the risk of suicidal ideation. This review investigations the interplay between immune-mediated neural damage and psychiatric manifestations in RRMS, suggesting that integrated treatment approaches targeting both neuroinflammation and mood disorders may offer improved case outcomes.MS is associated with various comorbidities, including neurological, psychiatric, cardiovascular, autoimmune, and metabolic disorders .Vascular conditions such as hypertension, type-2 diabetes, dyslipidemia, and cardiovascular disease are increasingly common in MS and may contribute to disability progression . Psychiatric comorbidities are also prevalent, with depression (23.7%), anxiety (21.9%), and bipolar disorder (5.83%) being most common. The lifetime prevalence of depression in MS is approximately 50%, influenced by factors such as female gender, younger age, family history, and psychosocial stress. Treatment options include pharmacotherapy and psychotherapy