Predictors of suicidal ideation in chronic pain patients: an exploratory study

Clin J Pain. 2014 May;30(5):371-8. doi: 10.1097/AJP.0b013e31829e9d4d.

Abstract

Objectives: To explore whether chronic pain (CP) patients who report suicidal ideation (SI) present a distinctive profile with regard to their sociodemographic characteristics, physical health, psychological well-being, cognitions, and use of antidepressants, illicit drugs, and alcohol for pain relief.

Methods: Eighty-eight CP patients completed self-administered questionnaires during their intake assessment at 3 pain clinics located in the province of Québec (Canada). Patients reporting active or passive SI on the Beck Depression Inventory were compared with patients reporting no SI. Between-group univariate analyses were performed using profile variables to compare patients with and without SI. Significant variables were then entered into multiple logistic regression analyses to identify significant independent predictors of SI.

Results: Twenty-four percent of patients reported having had SI. Unemployed/disabled patients were 6 times more likely to report SI. Poor sleep quality was the only predictor of SI among the physical variables. For psychological well-being, depressive symptoms did not significantly predict SI. However, the poorer the patients perceived their mental health to be the more likely they were to report SI. Pain-related helplessness was the only predictor for SI among the cognitive variables. Patients who had used illicit drugs as a form of pain relief at any time since pain onset were 5 times more likely to report SI. Similar results were obtained for those who were on antidepressants.

Discussion: Some factors associated with SI seem pain specific, whereas others are more generally associated with SI. Better identification and understanding of these factors is essential for the development of targeted suicide prevention programs for at-risk CP patients.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antidepressive Agents / therapeutic use
  • Attitude to Health
  • Canada
  • Chi-Square Distribution
  • Chronic Pain / complications*
  • Chronic Pain / psychology*
  • Cognition
  • Depression / diagnosis
  • Depression / drug therapy
  • Depression / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Psychiatric Status Rating Scales
  • Risk Factors
  • Sleep Wake Disorders / etiology*
  • Suicidal Ideation*
  • Surveys and Questionnaires

Substances

  • Antidepressive Agents