Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, MB, Canada.
Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
J Psychosom Res. 2021 Dec;151:110651. doi: 10.1016/j.jpsychores.2021.110651. Epub 2021 Oct 14.
Suicidality (ideation, plans, attempts) is elevated among those with chronic pain. However, population-based research is limited and studies primarily focus on mechanisms associated with increasing rather than decreasing risk. This study aimed to identify correlates associated with increased and decreased odds of suicidality among Canadians with usual pain/discomfort in a nationally representative sample.
Cross-sectional data from the 2012 Canadian Community Health Survey-Mental Health supplement (CCHS-MH; N = 25,113) identified individuals with usual pain/discomfort (i.e., chronic pain; n = 5891). Multiple logistic regressions examined correlates that may increase (disability, activity limitations) and decrease (social support, positive mental health, spirituality) odds of suicidality among individuals endorsing usual pain/discomfort.
Among those endorsing usual pain/discomfort, between 7.1% (suicide attempt) to 21.0% (suicide ideation) endorsed suicidality, notably higher than those without (2.0% vs 9.6% for suicide attempt and ideation, respectively). Both greater social support and positive mental health were associated with decreased odds of suicide ideation and attempts (adjusted odds ratio (AOR) range = 0.94-0.97). Those whose pain prevented most activities had increased odds of suicide plans and attempts (AOR range = 1.72-1.94). Additionally, greater disability was associated with increased odds of suicide ideation (AOR = 1.01, 95% CI[1.01-1.02], p < .001). A multivariable model including all risk and protective correlates found only positive mental health as significantly associated with decreased odds of suicide ideation and attempts.
These findings may inform targeted screening, prevention, and intervention strategies to promote resilience and mitigate risk, among those with usual pain/discomfort.
患有慢性疼痛的人群自杀意念（想法、计划、尝试）发生率较高。然而，基于人群的研究有限，且研究主要集中于与风险增加而非降低相关的机制。本研究旨在识别与加拿大有常见疼痛/不适人群自杀意念发生率增加和降低相关的因素，该研究使用的是全国代表性样本。
使用 2012 年加拿大社区健康调查-心理健康补充调查（CCHS-MH；N=25113）的横断面数据，确定有常见疼痛/不适（即慢性疼痛；n=5891）的个体。采用多项逻辑回归分析了可能增加（残疾、活动受限）和降低（社会支持、积极心理健康、精神信仰）常见疼痛/不适个体自杀意念发生率的相关因素。
在有常见疼痛/不适的个体中，有 7.1%（自杀尝试）至 21.0%（自杀意念）报告有自杀意念，显著高于没有疼痛/不适的个体（自杀尝试和自杀意念分别为 2.0%和 9.6%）。更高的社会支持和积极的心理健康都与自杀意念和尝试的可能性降低相关（调整后的比值比（AOR）范围为 0.94-0.97）。那些因疼痛而无法进行大多数活动的个体，自杀计划和尝试的可能性更高（AOR 范围为 1.72-1.94）。此外，更大的残疾与自杀意念的可能性增加相关（AOR=1.01，95%CI[1.01-1.02]，p<0.001）。纳入所有风险和保护相关因素的多变量模型仅发现积极的心理健康与自杀意念和尝试的可能性降低显著相关。
这些发现可能为有常见疼痛/不适的人群提供有针对性的筛查、预防和干预策略，以促进韧性和降低风险。
