Sauer Christina, Grapp Miriam, Bugaj Till J, Maatouk Imad
Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany.
National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany.
Eur J Cancer Care (Engl). 2022 Nov;31(6):e13650. doi: 10.1111/ecc.13650. Epub 2022 Jul 8.
Patients with cancer have a higher risk of suicidal ideation (SI) and suicidality than the general population. This study was designed to investigate the prevalence of SI and its association with psychosocial and sociodemographic factors and tumour entity.
In this observational cross-sectional study, 4372 adult patients with different cancer entities were enrolled. We assessed the outcome variables (i.e. SI, depressive and anxiety symptoms, mental and physical fatigue and sociodemographic data) using self-report questionnaires. Data were analysed via descriptive statistics, binomial logistic regression and structural equation modelling (SEM).
Among all patients, 627 (14.3%) reported SI, of whom 12.8% reported SI on several days, 0.9% on half of the days and 0.6% nearly every day. Age, anxiety, mental fatigue and the Patient Health Questionnaire-9 items 'feeling down, depressed and hopeless', 'feeling bad about oneself' and 'slowing or agitation' were significant predictors of SI. SEM, including all significant predictors with a latent depressiveness-demoralisation variable, explained 30.3% variance of SI, showing a good fit.
Our results showed that a significant number of patients with cancer show SI. Future long-term studies are needed to address the differential contribution of depression and demoralisation on SI in patients with cancer.
癌症患者出现自杀意念（SI）和自杀行为的风险高于普通人群。本研究旨在调查SI的患病率及其与心理社会因素、社会人口学因素和肿瘤类型的关联。
在这项观察性横断面研究中，纳入了4372例患有不同癌症类型的成年患者。我们使用自填问卷评估了结局变量（即SI、抑郁和焦虑症状、心理和身体疲劳以及社会人口学数据）。通过描述性统计、二项逻辑回归和结构方程模型（SEM）对数据进行分析。
在所有患者中，627例（14.3%）报告有SI，其中12.8%报告在数天内有SI，0.9%报告在一半的日子里有SI，0.6%报告几乎每天都有SI。年龄、焦虑、心理疲劳以及患者健康问卷-9项中的“情绪低落、沮丧和绝望”“对自己感觉不好”和“行动迟缓或坐立不安”是SI的显著预测因素。包含所有显著预测因素以及一个潜在的抑郁-士气低落变量的SEM解释了SI变异的30.3%，显示出良好的拟合度。
我们的结果表明，相当数量的癌症患者存在SI。未来需要进行长期研究，以探讨抑郁和士气低落对癌症患者SI的不同影响。
