Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands; Tilburg School of Behavioural and Social Sciences, Tranzo Department, Tilburg University, Tilburg, the Netherlands.
Netherlands Institute of Mental Health and Addiction, Department of Epidemiology, Utrecht, the Netherlands.
Gen Hosp Psychiatry. 2020 Mar-Apr;63:54-61. doi: 10.1016/j.genhosppsych.2018.11.005. Epub 2018 Nov 22.
To examine the longitudinal association between pain and suicidal ideation in the general adult population.
Data were used from two waves (baseline and three-year follow-up) of the Netherlands Mental Health Survey and Incidence Study-2. Persons without prior 12-month suicidal ideation at baseline were included in this study (N = 5242). Pain severity and interference due to pain in the past month were measured using the 36-item Short Form Health Survey. Suicidal ideation and DSM-IV mental disorders were assessed using the Composite International Diagnostic Interview. Logistic regression analyses were performed.
Moderate to very severe pain (OR 3.39, p < .001) and moderate to very severe interference due to pain (OR 2.35, p .01) were associated with a higher risk for incident suicidal ideation at follow-up after adjustment for baseline sociodemographic variables and mental disorders. No interaction effects were found between pain severity or interference due to pain and mental disorders.
Moderate to severe pain and interference due to pain are risk factors for suicidal ideation independently of concomitant mental disorders. We suggest taking assessment and management of suicidal ideation in patients with pain into account both in clinical treatment as well as in suicide prevention action plans.
在一般成年人群体中研究疼痛与自杀意念之间的纵向关联。
本研究使用了荷兰心理健康调查和发病率研究-2 的两个波次（基线和三年随访）的数据。本研究纳入了基线时无 12 个月内自杀意念的参与者（N=5242）。使用 36 项简短健康调查评估过去一个月的疼痛严重程度和疼痛所致干扰。使用复合国际诊断访谈评估自杀意念和 DSM-IV 精神障碍。进行逻辑回归分析。
中度至重度疼痛（OR 3.39，p<.001）和中度至重度疼痛所致干扰（OR 2.35，p<.01）与随访时新发自杀意念的风险增加相关，调整基线社会人口统计学变量和精神障碍后仍如此。疼痛严重程度或疼痛所致干扰与精神障碍之间未发现交互效应。
中度至重度疼痛和疼痛所致干扰是自杀意念的独立风险因素，与并存的精神障碍无关。我们建议在临床治疗和自杀预防行动计划中都考虑对疼痛患者的自杀意念进行评估和管理。
