Department of Psychology, University of Manitoba, Canada; Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Canada.
Department of Psychology, University of Manitoba, Canada; Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Canada; Department of Clinical Health Psychology, University of Manitoba, Canada; Department of Psychiatry, University of Manitoba, Canada.
J Affect Disord. 2019 Oct 1;257:562-567. doi: 10.1016/j.jad.2019.07.016. Epub 2019 Jul 5.
Generalized anxiety disorder (GAD) and chronic pain conditions commonly co-occur, and are both independently associated with suicidality; however, little is known about the impact of chronic pain on suicidality among individuals with GAD. The aim of this study was to examine the associations between comorbid GAD and chronic pain conditions with suicide ideation, plans, and attempts in a population-based sample.
We analyzed data from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH; N = 25,113). Multiple logistic regressions examined the associations between comorbid GAD and chronic pain conditions (i.e., arthritis, migraine, back pain; reference = GAD alone) with suicidality (i.e., ideation, plans, and attempts).
After adjusting for sociodemographics, other psychiatric conditions, and other chronic pain conditions, results indicated that compared to GAD alone, comorbid GAD and migraine was associated with increased odds of suicide ideation and plans (adjusted odds ratio (AOR) range: 2.55-3.00) and comorbid GAD and arthritis was associated with increased odds of suicide attempts (AOR = 4.10, 95% CI [1.05-16.01]).
The cross-sectional nature of the survey design does not permit causal assumptions regarding the emergent associations and the self-report assessment of chronic pain conditions may be associated with response biases.
Results highlight the burden of chronic pain on suicidality among individuals with GAD. These results emphasize the importance of assessing risk of suicidality among individuals with comorbid GAD and chronic pain conditions, particularly migraine and arthritis.
广泛性焦虑障碍（GAD）和慢性疼痛疾病通常同时发生，并且两者都与自杀意念独立相关；然而，对于 GAD 患者中慢性疼痛对自杀意念的影响知之甚少。本研究旨在检查共病 GAD 和慢性疼痛疾病与人群中自杀意念、计划和尝试之间的关联。
我们分析了 2012 年加拿大社区健康调查-心理健康（CCHS-MH；N=25,113）的数据。多项逻辑回归检验了共病 GAD 和慢性疼痛疾病（即关节炎、偏头痛、背痛；参考=GAD 单独）与自杀意念（即意念、计划和尝试）之间的关联。
在调整了社会人口统计学、其他精神疾病和其他慢性疼痛疾病后，结果表明，与 GAD 单独相比，共病 GAD 和偏头痛与自杀意念和计划的可能性增加相关（调整后的优势比（AOR）范围：2.55-3.00），而共病 GAD 和关节炎与自杀尝试的可能性增加相关（AOR=4.10，95%CI[1.05-16.01]）。
调查设计的横断面性质不允许对新出现的关联做出因果假设，并且慢性疼痛疾病的自我报告评估可能与响应偏差有关。
结果突出了慢性疼痛对 GAD 患者自杀意念的负担。这些结果强调了评估共病 GAD 和慢性疼痛疾病（特别是偏头痛和关节炎）患者自杀风险的重要性。
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