Suicide attempts in chronic pain patients

Suicide attempts in chronic pain patients. A register-based study | Jan 2014

Background

There are several studies about the relationship between depression and chronic non-malignant pain. These studies have shown that up to 50% of chronic pain patients are suffering from depression.

It is, therefore, reasonable to expect that pain patients would also have an increased risk of suicidal behaviour. This problem is not well studied.  

Since 1990 the Centre for Suicide Research, Odense, Denmark has registered all suicide attempts in patients residing in the Region of Funen, Denmark.

The Pain Clinic, Odense University Hospital receives patients with chronic pain from the entire Region of Southern Denmark.

Purpose

The purpose of the study has been:

To investigate, whether patients treated in the Pain Clinic during the period from 1 January 2004 to 31 December 2009 had an increased risk of suicide attempts compared with the background population.

Results

In the study period from 1 January 2004 to 31 December 2009 1871 patients residing in the Region of Funen in Denmark were referred to The Pain Clinic.

In the patient group 258 suicide attempts in 110 persons were registered. In all 6% of the patient group had attempted suicide.

An increased risk of suicide attempts was found in the pain population as the incidence rate ratio (IRR) was 3.76 95% CI (3.22; 4.40). No statistical significant differences between men and women were found.

Conclusion

In a chronic non-malignant pain population, referred to a pain clinic, the risk of suicide attempts was increased.

Implications

It is important to be aware of risk factors for suicidal behaviour, i.e. pain history, depression, anxiety, abuse problems, and social problems when caring for patients with chronic pain. More knowledge and training of the staff caring for chronic pain patients are needed to decrease the risk of suicidal behaviour.

Main Points

In a register study involving 1871 chronic pain patients in all 6% had attempted suicide.

Chronic pain patients have a 3.76 increased risk for suicide attempts.

Screening for risk factors is important in chronic pain patients.

Risk factors are psychiatric, social, abuse problems, “intractable” pain.

This is only the abstract of the article – the full text is available:

Article Outline

1. 1. Introduction
   1. 1.1. Frequency of suicidal behaviour
   2. 1.2. Methodological problems and recommendations
   3. 1.3. Purpose of the present study
2. 2. Materials and methods
   1. 2.1. Patient material
   2. 2.2. Study protocol ethical approval
   3. 2.3. The statistical method
3. 3. Results
4. 4. Discussion
   1. 4.1. Results in relation to previous studies
   2. 4.2. Risk factors for suicide attempts
   3. 4.3. Limitations of the study
   4. 4.4. Conclusion
   5. 4.5. Implications
5. Conflict of interest
6. References