University of North Carolina, Center for Functional GI and Motility Disorders, Chapel Hill, North Carolina 27516, USA.
J Pain. 2011 Oct;12(10):1032-9. doi: 10.1016/j.jpain.2011.03.004.
Adults who suffer from chronic pain are at increased risk for suicide ideation and attempts, but it is not clear whether adolescents with chronic pain are similarly at elevated risk. This study investigates whether chronic pain is associated with an increase in suicidal ideation/attempts independent of depression in a population sample of adolescents. We analyzed data from the National Longitudinal Study of Adolescent Health, a longitudinal study of a nationally representative sample of adolescents in the United States (N = 9,970). Most chronic pain was related to suicide ideation/attempt both in the last year (odds ratio [OR] 1.3-2.1) and during the subsequent year (OR 1.2-1.8). After controlling for depressive symptoms, headaches (OR = 1.3 last year, OR = 1.2 subsequent year) and muscle aches (OR = 1.3 last year) remained associated with suicide ideation but not suicide attempt. These findings show that chronic pain in adolescence is a risk factor for suicide ideation; this effect is partly but not fully explained by depression. Youth with comorbid depression and chronic pain are at increased risk of thinking about and attempting suicide. Clinicians should be alert to suicide ideation/attempt and comorbid depression in this at-risk population.
Adolescents who suffer from chronic pain are at increased risk for suicide ideation and attempt. Depressive symptoms account for the link between chronic pain and suicide attempt, but do not completely explain why adolescents with chronic pain show suicide ideation.
患有慢性疼痛的成年人自杀意念和自杀企图的风险增加,但目前尚不清楚患有慢性疼痛的青少年是否也面临更高的风险。本研究调查了在青少年人群样本中,慢性疼痛是否与自杀意念/企图的增加相关,而与抑郁无关。我们分析了美国全国青少年纵向健康研究的数据,这是一项对全国代表性青少年样本的纵向研究(N=9970)。在过去一年(优势比[OR]1.3-2.1)和随后一年(OR 1.2-1.8)中,大多数慢性疼痛都与自杀意念/企图相关。在控制了抑郁症状后,头痛(去年的 OR=1.3,随后一年的 OR=1.2)和肌肉疼痛(去年的 OR=1.3)仍然与自杀意念相关,但与自杀企图无关。这些发现表明,青少年时期的慢性疼痛是自杀意念的一个危险因素;这种影响部分但并非完全由抑郁解释。患有共病抑郁和慢性疼痛的青少年自杀意念和企图的风险增加。临床医生应警惕该高危人群的自杀意念/企图和共病抑郁。
患有慢性疼痛的青少年自杀意念和自杀企图的风险增加。抑郁症状解释了慢性疼痛与自杀企图之间的联系,但并不能完全解释为什么患有慢性疼痛的青少年会出现自杀意念。