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König RS, Paris DH, Sollberger M, Tschopp R. Identifying the mental health burden in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) patients in Switzerland: A pilot study. Heliyon 2024; 10:e27031. [PMID: 38434357 PMCID: PMC10907781 DOI: 10.1016/j.heliyon.2024.e27031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 02/09/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024] Open
Abstract
Background Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating chronic disease of significant public health and clinical importance. It affects multiple systems in the body and has neuro-immunological characteristics. The disease is characterized by a prominent symptom called post-exertional malaise (PEM), as well as abnormalities in the immune-inflammatory pathways, mitochondrial dysfunctions and disturbances in neuroendocrine pathways. The purpose of this study was to evaluate the impact of ME/CFS on the mental health and secondary psychosocial manifestations of patients, as well as their coping mechanisms. Method In 2021, a descriptive cross-sectional study was conducted in Switzerland. A self-administered paper questionnaire survey was used to gather data from 169 individuals diagnosed with ME/CFS. Results The majority of the patients (90.5%) reported a lack of understanding of their disease, resulting in patients avoiding talking about the disease due to disbelief, trivialization and avoidance of negative reactions. They felt most supported by close family members (67.1%). Two thirds of the patients (68.5%) experienced stigmatization. ME/CFS had a negative impact on mental health in most patients (88.2%), leading to sadness (71%), hopelessness for relief (66.9%), suicidal thoughts (39.3%) and secondary depression (14.8%). Half of the male patients experienced at least one suicidal thought since clinical onset. Factors significantly associated with depression were the lack of cure, disabilities associated with ME/CFS, social isolation and the fact that life was not worth anymore with ME/CFS. The three main factors contributing to suicidal thoughts were (i) being told the disease was only psychosomatic (89.5%), (ii) being at the end of one's strength (80.7%) and (iii) not feeling being understood by others (80.7%). Conclusion This study provided first time significant insights into the mental and psychological well-being of ME/CFS patients in Switzerland. The findings highlight the substantial experiences of stigmatization, secondary depression and suicidal thoughts compared to other chronic diseases, calling for an urgent need in Switzerland to improve ME/CFS patient's medical, psychological and social support, in order to alleviate the severe mental health burden associated with this overlooked somatic disease.
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Affiliation(s)
- Rahel Susanne König
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland
| | - Daniel Henry Paris
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of University of Basel, Switzerland
| | - Marc Sollberger
- Memory Clinic, University Center for Medicine of Aging Basel, Felix Platter-Hospital, Basel, Switzerland
- Department of Neurology, University Hospital Basel and University of Basel, 4002, Basel, Switzerland
| | - Rea Tschopp
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of University of Basel, Switzerland
- Armauer Hansen Research Institute, Jimma Road, 1005, Addis Ababa, Ethiopia
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Syed O, Jancic P, Fink AB, Knezevic NN. Drug Safety and Suicidality Risk of Chronic Pain Medications. Pharmaceuticals (Basel) 2023; 16:1497. [PMID: 37895968 PMCID: PMC10609967 DOI: 10.3390/ph16101497] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/13/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023] Open
Abstract
Chronic pain is one of the main leading causes of disability in the world at present. A variety in the symptomatology, intensity and duration of this phenomenon has led to an ever-increasing demand of pharmacological treatment and relief. This demand for medication, ranging from well-known groups, such as antidepressants and benzodiazepines, to more novel drugs, was followed by a rise in safety concerns of such treatment options. The validity, frequency, and diversity of such concerns are discussed in this paper, as well as their possible effect on future prescription practices. A specific caution is provided towards the psychological safety and toll of these medications, regarding suicidality and suicidal ideation. Most significantly, this paper highlights the importance of pharmacovigilance and underscores the necessity of surveillance programs when considering chronic pain medication.
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Affiliation(s)
- Osman Syed
- Advocate Illinois Masonic Medical Center, Department of Anesthesiology, Chicago, IL 60657, USA; (O.S.); (P.J.); (A.B.F.)
- Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL 60515, USA
| | - Predrag Jancic
- Advocate Illinois Masonic Medical Center, Department of Anesthesiology, Chicago, IL 60657, USA; (O.S.); (P.J.); (A.B.F.)
| | - Adam B. Fink
- Advocate Illinois Masonic Medical Center, Department of Anesthesiology, Chicago, IL 60657, USA; (O.S.); (P.J.); (A.B.F.)
- Harborview Medical Center, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98104, USA
| | - Nebojsa Nick Knezevic
- Advocate Illinois Masonic Medical Center, Department of Anesthesiology, Chicago, IL 60657, USA; (O.S.); (P.J.); (A.B.F.)
- Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA
- Department of Surgery, University of Illinois, Chicago, IL 60612, USA
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3
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Rentrop M, Zwanzger P. [Anxiety, agitation, suicidality - Psychiatric emergencies in the general hospital]. Dtsch Med Wochenschr 2023; 148:406-422. [PMID: 36940692 DOI: 10.1055/a-1967-6310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
Psychiatric emergencies are encountered by every physician - regardless of specialty. Nevertheless, psychiatric emergencies in general hospitals are often a very significant challenge. In this article, the most important psychiatric emergency situations, diagnostic aspects as well as corresponding therapy options are presented.
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Chen C, Pettersson E, Summit AG, Boersma K, Chang Z, Kuja-Halkola R, Lichtenstein P, Quinn PD. Chronic pain conditions and risk of suicidal behavior: a 10-year longitudinal co-twin control study. BMC Med 2023; 21:9. [PMID: 36600296 PMCID: PMC9814420 DOI: 10.1186/s12916-022-02703-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Understanding the relationship between chronic pain conditions and suicidal behavior-suicide attempt, other intentional self-harm, and death by suicide-is imperative for suicide prevention efforts. Although chronic pain conditions are associated with suicidal behaviors, these associations might be attributed to unmeasured confounding or mediated via pain comorbidity. METHODS We linked a population-based Swedish twin study (N=17,148 twins) with 10 years of longitudinal, nationwide records of suicidal behavior from health and mortality registers through 2016. To investigate whether pain comorbidity versus specific pain conditions were more important for later suicidal behavior, we modeled a general factor of pain and two independent specific pain factors (measuring pain-related somatic symptoms and neck-shoulder pain, respectively) based on 9 self-reported chronic pain conditions. To examine whether the pain-suicidal behavior associations were attributable to familial confounding, we applied a co-twin control model. RESULTS Individuals scoring one standard deviation above the mean on the general pain factor had a 51% higher risk of experiencing suicidal behavior (odds ratio (OR), 1.51; 95% confidence interval (CI), 1.34-1.72). The specific factor of somatic pain was also associated with increased risk for suicidal behavior (OR, 1.80; 95% CI, 1.45-2.22]). However, after adjustment for familial confounding, the associations were greatly attenuated and not statistically significant within monozygotic twin pairs (general pain factor OR, 0.89; 95% CI, 0.59-1.33; somatic pain factor OR, 1.02; 95% CI, 0.49-2.11) CONCLUSION: Clinicians might benefit from measuring not only specific types of pain, but also pain comorbidity; however, treating pain might not necessarily reduce future suicidal behavior, as the associations appeared attributable to familial confounding.
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Affiliation(s)
- C Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 17177, Stockholm, Sweden.
| | - E Pettersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 17177, Stockholm, Sweden
| | - A G Summit
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - K Boersma
- Center for Health and Medical Psychology (CHAMP), School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Z Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 17177, Stockholm, Sweden
| | - R Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 17177, Stockholm, Sweden
| | - P Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 17177, Stockholm, Sweden
| | - P D Quinn
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
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Pergolizzi J, Breve F, Magnusson P, Nalamasu R, LeQuang JAK, Varrassi G. Suicide by Opioid: Exploring the Intentionality of the Act. Cureus 2021; 13:e18084. [PMID: 34692299 PMCID: PMC8523441 DOI: 10.7759/cureus.18084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/18/2021] [Indexed: 11/26/2022] Open
Abstract
Opioid toxicity can result in life-threatening respiratory depression. Opioid-overdose mortality in the United States is high and increasing, but it is difficult to determine what proportion of those deaths might actually be suicides. The exact number of Americans who died of an opioid overdose but whose deaths might be classified as suicide remains unknown. It is important to differentiate between those who take opioids with the deliberate and unequivocal objective of committing suicide, that is, those with active intent, from those with passive intent. The passive-intent group understands the risks of opioid consumption and takes dangerous amounts, but with a more ambiguous attitude toward suicide. Thus, among decedents of opioid overdose, a large population dies by accident, whereas a small population dies intending to commit suicide; but between them exists a sub-population with equivocal intentions, waxing and waning between their desire to live and the carelessness about death. There may be a passive as well as active intent to commit suicide, but less is known about the passive motivation. It is important for public health efforts aimed at reducing both suicides and opioid-use disorder to better understand the range of motivations behind opioid-related suicides and how to combat them.
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Affiliation(s)
| | - Frank Breve
- Department of Pharmacy, Temple University, Philadelphia, USA
| | - Peter Magnusson
- Cardiology, Center of Research and Development Region Gävleborg, Uppsala University, Gävle, SWE.,Medicine, Cardiology Research Unit, Karolinska Institutet, Stockholm, SWE
| | - Rohit Nalamasu
- Department of Physical Medicine and Rehabilitation, University of Nebraska Medical Center, Omaha, USA
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Characteristics associated with later self-harm hospitalization and/or suicide: A follow-up study of the HUNT-2 cohort, Norway. J Affect Disord 2020; 276:369-379. [PMID: 32871667 DOI: 10.1016/j.jad.2020.03.163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/20/2020] [Accepted: 03/29/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND To improve suicide and self-harm prevention in adults, better knowledge on preexisting characteristics and risk factors is of great importance. METHODS This is a population-based case-control study; baseline measures were collected in the second wave of the North-Trøndelag Health Study (HUNT-2, 1995-1997) in Norway, and outcomes were observed for up to 19 years. Average follow up time was 4.9 years for self-harm and 6.8 years for suicides. Out of 93,898 eligible adult inhabitants aged 20 and above, a total of 65,229 (70%) participated in the study. The data were linked to the National Mortality Registry and hospital patient records in the three hospitals covering the HUNT-2 catchment area. RESULTS Among the participants, 332 patients (68% women) were hospitalized because of self-harm (HSH), and 91 patients (32% women) were died by suicide (SU). A total of 10% of those who died by SU had previously been HSH. People in the HSH and SU groups were younger, reported more depression and anxiety symptoms, sleeping problems, higher use of alcohol and tobacco, poorer social network and more economic problems, compared to the rest of the HUNT-2 population. In addition, the HSH group reported more somatic health problems, higher use of health services, higher sick leave, and lower work participation than the SU group. LIMITATIONS Younger adults (20-40 years) were under-represented in HUNT-2. Younger adults (20-40 years) were constituted 31.7% in HUNT-2, 50% in HSH and 33% in SU. Further, we did not identify less severe self-harm, not requiring hospitalization. Life changes, adverse events, and other possible triggers to self-harming behavior were not recorded. CONCLUSION Psychological problems were long-term predictors of both HSH and SU. Somatic health problems and lower functional performance were more present in HSH-group compared to the SU-group.
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7
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D’Ippolito M, Purgato A, Buzzi MG. Pain and Evil: From Local Nociception to Misery Following Social Harm. J Pain Res 2020; 13:1139-1154. [PMID: 32547177 PMCID: PMC7250527 DOI: 10.2147/jpr.s236507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/07/2020] [Indexed: 01/03/2023] Open
Abstract
Experiencing pain, especially when chronic, is an excruciating condition that should be regarded as a syndrome, if not a disease. People suffering from chronic pain tend to develop psychological discomfort mostly due to lack of acceptance, disbelief, blame. The complexity of pain pathophysiology, plus a wide range of negative psychosocial factors, leads to a more complex suffering that deserves attention and multidisciplinary treatments. The possibility that chronic pain may occur following physical aggression, torture, or persecution raises the issue of evil as a major contributor to pain in its worst representation - when individuals or groups are attacked based on racial, social, gender, religious, political, or other grounds. To explore the complex issue of chronic pain following physical or psychological harm, and to underscore the need for a multidisciplinary approach to reduce the burden of chronic pain, we discuss the biological mechanisms underlying pain state. We seek to clarify those factors leading to pain chronification, as well as personal and social attitudes that confound patients with chronic pain. The importance of family and social environment is also investigated, as well as personality traits of chronic pain patients that may further hamper successful treatment. The presence of chronic pain, modulated by, for example, acceptance of being a victim of premeditated physical and social violence, makes the issue more difficult to comprehend.
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Affiliation(s)
| | - Adriano Purgato
- National Health System, Azienda USL Roma 2, Rome00157, Italy
| | - Maria Gabriella Buzzi
- Neurorehabilitation 2, Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome00179, Italy
- Headache Centre, IRCCS Fondazione Santa Lucia, Rome00179, Italy
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8
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Owen-Smith AA, Ahmedani BK, Peterson E, Simon GE, Rossom RC, Lynch FL, Lu CY, Waitzfelder BE, Beck A, DeBar LL, Sanon V, Maaz Y, Khan S, Miller-Matero LR, Prabhakar D, Frank C, Drake CL, Braciszewski JM. The Mediating Effect of Sleep Disturbance on the Relationship Between Nonmalignant Chronic Pain and Suicide Death. Pain Pract 2019; 19:382-389. [PMID: 30462885 DOI: 10.1111/papr.12750] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/08/2018] [Accepted: 11/14/2018] [Indexed: 11/30/2022]
Abstract
IMPORTANCE Few studies have examined the relationship between nonmalignant chronic pain (NMCP) and suicide death, and even fewer have specifically explored what role sleep disturbance might play in the association between NMCP and suicide death. OBJECTIVE To assess whether sleep disturbance mediates the relationship between NMCP and suicide death. DESIGN This case-control study included 2,674 individuals who died by suicide between 2000 and 2013 (cases) and 267,400 matched individuals (controls). SETTING Eight Mental Health Research Network (MHRN)-affiliated healthcare systems. PARTICIPANTS All cases and matched controls were health plan members for at least 10 months during the year prior to the index date. MAIN OUTCOMES AND MEASURES Sociodemographic data and diagnosis codes for NMCP and sleep disorders were extracted from the MHRN's Virtual Data Warehouse. Suicide mortality was identified using International Statistical Classification of Diseases and Related Health Problems (ICD)-10 codes from official government mortality records matched to health system records. RESULTS After accounting for covariates, there was a significant relationship between NMCP and sleep disturbance; those who were diagnosed with NMCP were more likely to develop subsequent sleep disturbance. Similarly, sleep disturbance was significantly associated with suicide death. Finally, a significant indirect effect of NMCP on suicide death, through sleep disturbance, and a nonsignificant direct effect of NMCP on suicide death provide support for a fully mediated model. CONCLUSIONS AND RELEVANCE There is a need for clinicians to screen for both sleep disturbance and suicidal ideation in NMCP patients and for health systems to implement more widespread behavioral treatments that address comorbid sleep problems and NMCP.
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Affiliation(s)
- Ashli A Owen-Smith
- School of Public Health, Georgia State University, Atlanta, Georgia, U.S.A.,Kaiser Permanente Georgia, Center for Research and Evaluation, Atlanta, Georgia
| | - Brian K Ahmedani
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, U.S.A.,Behavioral Health Services, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Ed Peterson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Gregory E Simon
- Kaiser Permanente Washington, Health Research Institute, Seattle, Washington, U.S.A
| | | | - Frances L Lynch
- Kaiser Permanente Northwest, Center for Health Research, Portland, Oregon, U.S.A
| | - Christine Y Lu
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, U.S.A
| | - Beth E Waitzfelder
- Kaiser Permanente Hawaii, Center for Health Research, Honolulu, Hawaii, U.S.A
| | - Arne Beck
- Kaiser Permanente Colorado, Institute for Health Research, Aurora, Colorado, U.S.A
| | - Lynn L DeBar
- Kaiser Permanente Washington, Health Research Institute, Seattle, Washington, U.S.A
| | - Victoria Sanon
- School of Public Health, Georgia State University, Atlanta, Georgia, U.S.A
| | - Yousef Maaz
- Behavioral Health Services, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Shehryar Khan
- Behavioral Health Services, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Lisa R Miller-Matero
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, U.S.A.,Behavioral Health Services, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Deepak Prabhakar
- Behavioral Health Services, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Cathy Frank
- Behavioral Health Services, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Christopher L Drake
- Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Jordan M Braciszewski
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, U.S.A
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Racine M. Chronic pain and suicide risk: A comprehensive review. Prog Neuropsychopharmacol Biol Psychiatry 2018; 87:269-280. [PMID: 28847525 DOI: 10.1016/j.pnpbp.2017.08.020] [Citation(s) in RCA: 185] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/07/2017] [Accepted: 08/23/2017] [Indexed: 12/24/2022]
Abstract
Death by suicide is one of the leading causes of mortality worldwide. Because individuals with chronic pain are at least twice as likely to report suicidal behaviors or to complete suicide, it is of utmost importance to target which risk factors contribute the most to increasing suicidality. This comprehensive review aims to provide an update on research advancements relating to the identification of potential risk factors for suicidality in individuals with chronic pain. Supporting the results of prior reviews, we found robust evidence that chronic pain itself, regardless of type, was an important independent risk factor for suicidality. The only sociodemographic factor found to be associated with suicidality in individuals with chronic pain was being unemployed/disabled. Depressive symptoms, anger problems, harmful habits (e.g. smoking, alcohol misuse, illicit drugs), childhood or adulthood adversities, and family history of depression/suicide were all also identified as general risk factors. Regarding pain-related factors, sleep problems, poorer perceived mental health, concurrent chronic pain conditions, and more frequent episodes of intermittent pain, were all found to be predictors of suicidality. Unexpectedly, pain characteristics (e.g. type, duration, and intensity/severity) and physical status (e.g. pain interference or disability) were not related to suicide risk. We also identified promising new psychosocial factors (e.g. mental defeat, pain catastrophizing, hopelessness, perceived burdensomeness and thwarted belongingness) associated with suicidality outcomes. A large number of these factors are amenable to change through targeted intervention, highlighting the importance of comprehensively assessing chronic pain patients at risk for suicide, while also incorporating a suicide prevention component into chronic pain management programs.
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Affiliation(s)
- Mélanie Racine
- Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
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10
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Alvarado-Esquivel C. Suicidal Ideation and Suicide Attempts in Middle-Aged Women Attending a Primary Care Center: A Cross-Sectional Study in Mexico. J Clin Med Res 2018; 10:693-699. [PMID: 30116439 PMCID: PMC6089572 DOI: 10.14740/jocmr3501w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 06/28/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Very little is known about suicide attempts in middle-aged women in Mexico. The aims of this study were to determine: 1) the prevalence of suicidal ideation and suicide attempts in middle-aged women in Durango City, Mexico; and 2) the suicide attempt prevalence association with the sociodemographic, clinical, and behavioral characteristics of the women studied. METHODS Through a cross-sectional study, 395 middle-aged women were surveyed. Suicidal ideation, suicide attempt data, and the characteristics of the women were obtained with the aid of a questionnaire. Bivariate and multivariate analyses were used to determine the association between suicide attempts and the characteristics of women. RESULTS Of the 395 women (mean age: 46.97 ± 5.34 years) studied, 50 (12.7%) had suicide ideation, and 20 (5.1%) had suicide attempts. The number of suicide attempts among these 20 women varied from 1 to 10 times. The most frequent method used for suicide attempt was intake of medicaments (in 11 women). None of the sociodemographic characteristics was associated with suicide attempts. Women with suicide ideation, abdominal pain frequently, and reflexes impairment had a significantly higher frequency of suicide attempts than those without these characteristics. Logistic regression of behavioral variables showed that only the variable alcohol consumption was independently associated with suicide attempts (odds ratio = 2.82; 95% confidence interval: 1.01 - 7.84; P = 0.04). CONCLUSIONS Results suggest that suicidal ideation and suicide attempts are prevalent among women of middle-age attending a public primary care center in Durango City. This is the first report of an association between suicide attempts and reflexes impairment. Factors associated with suicide attempts found in this study may help in the design of preventive measures against suicide.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Dgo, Mexico.
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11
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Lafuente-Castro CP, Ordoñez-Carrasco JL, Garcia-Leiva JM, Salgueiro-Macho M, Calandre EP. Perceived burdensomeness, thwarted belongingness and suicidal ideation in patients with fibromyalgia and healthy subjects: a cross-sectional study. Rheumatol Int 2018; 38:1479-1486. [PMID: 29858648 DOI: 10.1007/s00296-018-4067-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 05/26/2018] [Indexed: 02/02/2023]
Abstract
Perceived burdensomeness and thwarted belongingness are key factors in the development of suicidal behaviors that have been frequently observed among patients with fibromyalgia. The aim of the present study was to compare these two factors in patients with fibromyalgia with and without suicidal ideation and healthy subjects. Secondary objectives were to evaluate the relationship between these two factors and the secondary variables included in the study, such as depression, sleep quality or the degree of marital adjustment. Perceived burdensomeness and thwarted belongingness were assessed with the Interpersonal Needs Questionnaire, depression and suicidal ideation with the Patients Health Questionnaire-9, suicidal risk with the Plutchik Suicide Risk scale, sleep with the Insomnia Severity Index, and marital adjustment with the Locke-Wallace Marital Adjustment scale. Questionnaire scores were compared with the Kruskal-Wallis test. 49 healthy subjects, 38 patients with fibromyalgia without suicidal ideation and 15 patients with fibromyalgia and suicidal ideations were included. Perceived burdensomeness scores were significantly higher in patients with suicidal ideation than in patients without suicidal ideation and controls; thwarted belongingness scores were significantly higher in patients with suicidal ideation than in controls. Marital adjustment was also significantly poor in patients with suicidal ideation than in patients without suicidal ideation and controls. Among patients with fibromyalgia, perceived burdensomeness seems to be strongly related with suicidal ideation, whereas thwarted belongingness seems to play a less relevant role at this respect. Poor marital adjustment could be related with depression.
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Affiliation(s)
- Cristina P Lafuente-Castro
- Instituto de Neurociencias, Universidad de Granada, Avenida del Conocimiento s/n, 18100 Armilla, Granada, Spain
| | | | - Juan M Garcia-Leiva
- Instituto de Neurociencias, Universidad de Granada, Avenida del Conocimiento s/n, 18100 Armilla, Granada, Spain
| | - Monika Salgueiro-Macho
- Departamento de Psiquiatría, Hospital Universitario Cruces, Instituto de Investigación Sanitaria Biocruces-HRi, Barakaldo, Spain
| | - Elena P Calandre
- Instituto de Neurociencias, Universidad de Granada, Avenida del Conocimiento s/n, 18100 Armilla, Granada, Spain.
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13
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Pederson CL, Gorman-Ezell K, Hochstetler-Mayer G. Invisible Illness Increases Risk of Suicidal Ideation: The Role of Social Workers in Preventing Suicide. HEALTH & SOCIAL WORK 2017; 42:183-186. [PMID: 28859425 DOI: 10.1093/hsw/hlx029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 10/12/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Cathy L Pederson
- Department of Biology, Wittenberg University, Springfield, OH. Department of Social Work, Ohio Dominican University, Columbus. Mental Health and Recovery Board of Clark, Green, and Madison Counties, Springfield, OH
| | - Kathleen Gorman-Ezell
- Department of Biology, Wittenberg University, Springfield, OH. Department of Social Work, Ohio Dominican University, Columbus. Mental Health and Recovery Board of Clark, Green, and Madison Counties, Springfield, OH
| | - Greta Hochstetler-Mayer
- Address correspondence to Kathleen Gorman-Ezell, Department of Social Work, Ohio Dominican University, 1216 Sunbury Road, Columbus, OH 43219; e-mail:
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Athey A, Overholser J. Learning from Physical Pain to Help with the Management of Emotional Pain. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2016. [DOI: 10.1007/s10879-016-9330-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kim DK, Song HJ, Lee EK, Kwon JW. Effect of sex and age on the association between suicidal behaviour and obesity in Korean adults: a cross-sectional nationwide study. BMJ Open 2016; 6:e010183. [PMID: 27256086 PMCID: PMC4893869 DOI: 10.1136/bmjopen-2015-010183] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To examine the hypothesis that the relationship between obesity and the risk of suicidal behaviour would differ according to sex and age. SETTING Data from the 2007-2012 Korean National Health and Nutrition Examination Survey (KNHANES) were used. PARTICIPANTS 36 211 adults with body mass index (BMI) data were included and the mean age was 49.6 years. INDEPENDENT VARIABLE BMI. PRIMARY AND SECONDARY OUTCOME MEASURES Suicide ideation and attempts. DESIGN AND ANALYSIS A cross-sectional study was performed. Multiple logistic regressions after controlling for socioeconomic variables and concomitant diseases were applied to see the relationship between obesity level and suicidal ideation or attempt. RESULTS Women with severe obesity had the highest prevalence of suicide attempts and ideation, whereas among males, underweight men had the highest prevalence. After adjustment, obese men had a lower OR for suicide ideation (OR=0.87, 95% CI 0.76 to 1.00). Among women, the ORs of severely obese and underweight women were 1.27 (95% CI 1.06 to 1.52) and 1.24 (95% CI 1.06 to 1.45), respectively. When grouped by age category, the ORs for suicide ideation in severely obese women aged 18 to <30 years or attempts in severely obese women aged 30 to <50 years were 2.30 (95% CI 1.36 to 3.89) and 3.07 (95% CI 1.50 to 6.31), respectively. However, overweight and obese women aged more than 50 years exhibited significantly less ORs of suicide ideation, when compared with counterparts of normal weight. CONCLUSIONS The association between obesity and suicidal behaviour exhibited a different pattern by sex and age in South Korea. In particular, severely obese young women had a substantial risk of suicidal behaviour. Our study results highlighted the importance of obesity management in the prevention of suicide among young women, and may be helpful for the drafting of the health agenda in Asian countries with an obesity prevalence and culture similar to those in Korea.
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Affiliation(s)
- Dae-Kwon Kim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Republic of South Korea
- Daegu Gyeongbuk Medical Innovation Foundation, Daegu, Republic of South Korea
| | - Hyun Jin Song
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Republic of South Korea
| | - Eui-Kyung Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of South Korea
| | - Jin-Won Kwon
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Republic of South Korea
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Calati R, Laglaoui Bakhiyi C, Artero S, Ilgen M, Courtet P. The impact of physical pain on suicidal thoughts and behaviors: Meta-analyses. J Psychiatr Res 2015; 71:16-32. [PMID: 26522868 DOI: 10.1016/j.jpsychires.2015.09.004] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/11/2015] [Accepted: 09/10/2015] [Indexed: 11/25/2022]
Abstract
Although the relationship between physical pain and suicidal thoughts and behaviors has been explored in multiple epidemiologic and clinical studies, it is still far from being well understood. Consequently, we conducted a meta-analysis of studies comparing rates of suicidal thoughts and behaviors in individuals with and without physical pain. We searched MEDLINE and PsycINFO (May 2015) for studies comparing rates of current and lifetime suicidal thoughts and behaviors (death wish, suicide ideation, plan, attempt and death: DW, SI, SP, SA, SD) in individuals with any type of physical pain (headache, back, neck, chest, musculoskeletal, abdominal and pelvic pains, arthritis, fibromyalgia, medically unexplained pain, and other not specified pain) versus those without it. Data were analyzed with Cochrane Collaboration Review Manager Software (RevMan, version 5.3). We assessed the methodological quality of the studies with the STROBE statement. Of the 31 included studies, three focused on lifetime DW, twelve focused on current SI (six lifetime), six focused on current SP (two lifetime), nine focused on current SA (11 lifetime) and eight on SD. Individuals with physical pain were more likely to report lifetime DW (p = 0.0005), both current and lifetime SI (both p < 0.00001), SP (current: p = 0.0008; lifetime: p < 0.00001), and SA (current: p < 0.0001; lifetime: p < 0.00001). Moreover, they were more likely to report SD (p = 0.02). In all analyses, the between study heterogeneity was high. Moreover, the presence of publication bias has been detected in the main outcomes. Physical pain is a consistent risk factor for suicidal thoughts and behaviors. Further research is required to investigate the specific impact of: 1) chronic versus acute pain, 2) different types of pain (e.g., medically unexplained pain), and 3) risk factors for suicide in chronic pain patients.
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Affiliation(s)
- Raffaella Calati
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, France.
| | - Camelia Laglaoui Bakhiyi
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; Psychiatric Unit, CHU Casablanca, Hassan II University, Casablanca, Morocco
| | - Sylvaine Artero
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France
| | - Mark Ilgen
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; University of Michigan Department of Psychiatry, Ann Arbor, MI, USA
| | - Philippe Courtet
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, France
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