Predictors of Suicidal Ideation in Chronic Pain Patients

Predictors of Suicidal Ideation in Chronic Pain Patients

Suicide has always been a very sensitive topic to touch upon, whether it be about “suicidal ideations” (SI), “suicide attempts” (SA) or — god forbid — suicide completion. According to the World Health Organization, death by suicide is one of the leading causes of mortality rate every year (16 per 100, 000 individuals) [6]. The worldwide lifetime prevalence for passive (without plan) and active (with a plan) SI, and SA have been estimated to be 9.2%, 3.1% and 2.7% respectively

Suffering from chronic pain (CP) seems to be an important at-risk factor for suicidality. A recent literature review has demonstrated that in comparison to the general population, individuals with CP where 2 to 3 times more likely to exhibit SI, SA and to complete suicide.

Results showed that patients that were unemployed/disabled were 6 times more likely to report SI.

One explanation might be that these patients succumb to negative cognitions such as guilt and helplessness due to their perceived uselessness and diminution of social role (e.g. purveyor).

This whole study is written in the language of disempowerment, subtly belittling and invalidating the chronic pain experience.

Why write that chronic pain patients “succumb” to negative cognitions (not even an English word) when they simply feel guilty and helpless?  It seems very normal to feel guilty and helpless when robbed of ones physical strength, energy, and abilities by devastating pain that isn’t visible and has no obvious cause. By using the word “succumb” they give these normal human reactions an aura of failure.

Perhaps these researchers didn’t know that many studies have shown that our society views and treat the disabled as useless and of dismissed social importance.  Those of us stricken with chronic pain certainly notice the difference between how we were treated before and after. Our social devaluation is not just a “perceived notion”.

In their choice of vocabulary and the way this article was written, these researchers have completely dismissed our very real on-the-ground experience of what it’s like to live with chronic pain in this society.  

Another plausible explanation may be that patients reporting SI had more difficulty in coping with their pain, making it harder for them to convince themselves of returning to work.

Notice that they don’t say it’s harder for them to return to work, but rather that it’s harder for them to convince themselves to return to work, which makes it sound like a person can control their ability to work by “convincing themselves”.  Such a ridiculous idea has no place in a scientific paper.

In line with previous literature, we also found that poor sleep quality was the only predictor of SI among the physical variables tested. We have also obtained a surprising result, namely that depressive symptoms did not significantly predict SI when mental health was taken into account — i.e. the poorer the patients perceived their mental health to be, the more likely they were to report SI. Interestingly, our results are in line with the ones found in the Quebec’s general population where SI prevalence was only 3% in individuals who judged their mental health to be good, very good or excellent, 15% in those who thought it was average, and 43% in those who perceived it to be poor

This study also seems to be saying that chronic pain does not increase suicidal thoughts, yet this directly contradicts the personal experiences of pain patients.

Too many of these studies do not correlate with our reality.


3 thoughts on “Predictors of Suicidal Ideation in Chronic Pain Patients

  1. todd

    I am in the midst of one of the worst flair ups I have had since I was diagnosed 7 years ago. I work 40 to 60hrs a week in a very physical job. I am at my end I cant stop working because my family depends on me to provide. Being a male I sometimes wonder if it can be harder because we are supposed to be strong and the fact there are less men with fibro than women. I have always been known as superman to my friends and family. Now I am feeling isolated and can barely make it thru the day. I went thru all the Dr’s who didnt believe me or think the disease is real and still I am here breathing but feeling barely alive. The pain and exhaustion has been so bad for so long I honestly dont really know how much longer I can deal with it. I am grateful for the dr I have now she really tries to give me at least some quality of life but I am tired of the pills and the way they make me feel but what is there to do? here I am searching for answers to why I went from being a man who was always regarded as smart, funny, and energetic to isolated and depleted of energy from the constant pain and stress it brings. So for a man that is tired of being in pain what options are there? I eat healthy, get massages, and stretch more than 10 people. At least if I decide its not worth the fight anymore I know financially my family will be taken care of I have made sure of that. I am not saying that is what I want I just want this all to go away and have my life back!! And to all the ones who say we just have a mental disease, condition, disorder, or what ever they want to call it. Trade me for one day and you will jumping off a tall building before dinner time! And Btw I have seen a therapist (dr wanted to get their opinion) and in my evaluation report it stated that the patient shows no signs of depression. It was in their opinion that I was in real pain and that any suicidal thoughts were the direct result of being constantly in pain. So for all the nay sayers walk a mile in my shoes….


  2. Zyp Czyk Post author

    Hello Todd,

    I’m so sorry you’re in such terrible pain right now – I can “hear” your anguish. You’re certainly not the only one who has wished a day of our own pain onto folks who don’t believe it’s real. How else can we make them understand what we live with on a daily basis? I can forgive ignorance, but not when it’s used as a weapon against us.

    I hope you’re able to reach out for some support from family, friends, neighbors, or even online forums when things get this bad.

    Hang in there.



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