Severe pain predicts greater likelihood of suicide

Severe pain predicts greater likelihood of subsequent suicide. – PubMed – NCBI – Suicide Life Threat Behav. 2010 Dec

Using data from the 1999 Large Health Survey of Veterans, Veterans Affairs’ medical records, and the National Death Index (N = 260,254), the association between self-reported pain severity and suicide among veterans as examined, after accounting for demographic variables and psychiatric diagnoses.

A Cox proportional hazards regression demonstrated that veterans with severe pain were more likely to die by suicide than patients experiencing none, mild, or moderate pain (HR: 1.33; 95% CI: 1.15, 1.54), after controlling for demographic and psychiatric characteristics.

These results indicate that pain evaluations should be included in comprehensive suicide assessments and suicide prevention efforts.

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4 thoughts on “Severe pain predicts greater likelihood of suicide

  1. Laura P. Schulman, MD, MA

    Arrgh, network glitch! The authors follow the convention of excluding people with psych diagnoses because we are higher suicide risks and could skew the results. BUT. They neglect the factor of psychic PAIN, which is why people with mental illness suicide! And then there’s the problem of “mental illness” being on the list of reasons to withhold opioid pain medication from someone who is unfortunate enough to suffer from both psychic AND physical pain! (Wouldn’t want them to go ahead and use their meds for euthanasia….)

    There is a myth that mental illness “is a treatable condition,” so we must “treat” that and “control” it before we can really assess whether and how to treat that person’s physical pain. Unfortunately, serious mental illness (bipolar, schizophrenia, major depressive disorder) is a lifelong chronic illness that causes intense suffering, sometimes punctuated with remissions lasting weeks or months but not years in most cases. If we staunchly refuse to treat those people, if we exclude them from studies, how in the world can we expect them to keep living in a world of pain, with no hope of relief?

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      It’s impossible to completely untangle and separate the mental and physical aspects of human functioning: chronic pain has many and deep influences on our mental state.

      I agree that studies on pain cannot simply exclude anyone with a “mental disorder” because it would only be a matter of degree.

      Mental illness or not, without opioids most chronic pain patients are “living in a world of pain, with no hope of relief”

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      Reply
  2. Pingback: Suicidality in chronic pain | EDS and Chronic Pain News & Info

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