Affiliation:
1. Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
2. Canandaigua VA Medical Center, Canandaigua, New York, USA
3. VA Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, Canandaigua, New York, USA
4. Department of Psychiatry, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
Abstract
Abstract
Objective
Specific pain conditions such as back pain and migraines are associated with increased risk of suicide mortality after accounting for key covariates. The purpose of the current study was to assess the associations of specific pain conditions with suicide attempts.
Design
Case-control
Setting
Veterans Health Administration (VHA)
Subjects
Individuals who utilized VHA services with a record of a suicide attempt (N = 30,051) in Fiscal Years 2013 and 2014 were identified and propensity score matched with controls with no such record (N = 30,051).
Methods
Data on pain condition diagnoses (back pain, arthritis, migraine, headaches, psychogenic pain, neuropathy, fibromyalgia) psychiatric diagnoses, medical comorbidity, and demographics were extracted from VHA medical record and suicide surveillance datasets.
Results
Unadjusted logistic regression analyses found that each of the pain conditions were associated with suicide attempts (e.g., back pain: Odds ratio [OR]=3.25, 95% Confidence Interval [CI]=3.12–3.39). After adjusting for mental health conditions, medical comorbidity, and each of the pain conditions, the effects were attenuated across pain conditions; however, remained significant for each of the pain conditions except for fibromyalgia. Specifically, back pain (OR = 1.25, 95% CI = 1.19–1.32), migraines (OR = 1.29, 95% CI = 1.14–1.46), headaches (OR = 1.33, 95% CI = 1.19–1.48), and neuropathic pain (OR = 1.52, 95% CI = 1.33–1.74) were each associated with increased odds of a suicide attempt. Fibromyalgia was the only pain condition associated with re-attempt status (OR = 1.25, 95% CI = 1.08–1.45).
Conclusions
Specific pain conditions are associated with increased odds of suicide attempts even after including key covariates.
Limitations
Limitations of the study include the retrospective study design and lack of examination into additional variables including prescription opioid use, pain intensity, and pain duration. The case-control design also limits the ability to draw causal or temporal conclusions.
Funder
Advanced Fellowship Program
Mental Health Illness Research and Treatment
Department of Veterans Affairs or the United States Government
Publisher
Oxford University Press (OUP)
Subject
Anesthesiology and Pain Medicine,Neurology (clinical),General Medicine
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献