Chronic Pain Can Lead To High Risk Of Suicide

While the rates of other causes of death have declined in recent years, suicide continues to trend upwards across all ages and genders. Many people who die by suicide do not have a prior mental health diagnosis, which means that patients at an increased risk for self-harm are somehow being missed by the mainstream healthcare system.

About 800,000 people commit suicide worldwide every year, of these 17% are residents of India. On an average a total number of suicides in India per day is 300!! As per the reports of Accidental Deaths and Suicides in India 2014 and National Crime Records Bureau, Ministry of Home Affairs, the total number of suicides in India as per 2014 statistics is 1,09,456 out of which 47,242 suicides were driven by prolonged illness and chronic pain.

According to a new study, published in the American Journal of Preventive Medicine, chronic illness including back pain, diabetes, and heart disease, even in patients with no record of mental health problems, raises suicide risk substantially. "The data represents among the first findings from areas across the U.S. documenting an increase in suicide risk for people with a variety of major physical health conditions," explained lead investigator Brian K. Ahmedani.

This study included 2,674 individuals who died by suicide between 2000 and 2013 along with 267,400 controls matched on year and location in a case-control study across eight Mental Health Research Network healthcare systems. Seventeen of 19 medical conditions investigated were linked to an increased suicide risk: asthma, back pain, brain injury, cancer, congestive heart failure, chronic obstructive pulmonary disorder, diabetes, epilepsy, HIV/AIDS, heart disease, hypertension, migraine, Parkinson's disease, psychogenic pain, renal disorder, sleep disorders, and stroke.

While all of these conditions were associated with greater risk, some conditions showed a stronger association than others. Sleep disorders and HIV/AIDS represented a greater than twofold increase, while traumatic brain injury made individuals nine times more likely to die by suicide, the study said." Along with varying rates among conditions, having multiple physical health conditions also substantially increased risk.

"Although suicide risk appears to be pervasive across most physical health conditions, prevention efforts appear to be particularly important for patients with a traumatic brain injury, whose odds of suicide are increased nearly nine-fold even after adjusting for potential confounders," reported Dr. Ahmedani. "This is the first large, multisite study conducted within the general U.S. population demonstrating a significant, large-magnitude relationship between brain injury and suicide."

According to this research, targeted interventions in primary care and speciality care may be the key to preventing suicides. It's reported that 80% of individuals who die by suicide make a healthcare visit in the year before their death and that 50% go to the doctor within four weeks of dying by suicide. Because most these patients do not have a diagnosed mental health problem, limiting suicide prevention efforts to standard behavioural healthcare settings may miss many of the individuals at risk.

"Several conditions, such as back pain, sleep disorders, and traumatic brain injury were all associated with suicide risk and are commonly diagnosed, making patients with these conditions primary targets for suicide prevention," concluded Dr. Ahmedani. "Given that nearly every physical health condition was associated with suicide, widespread suicide prevention efforts in all healthcare settings seem warranted."
 
(Inputs by ANI)