Torino Gabriele, Rignanese Martina, Salmè Eleonora, Madeddu Fabio, Courtet Philippe, Forget Jelena, Attali David, Kalisch Larissa, Baeza-Velasco Carolina, Lopez-Castroman Jorge, Fornaro Michele, Calati Raffaella
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Department of Psychology, University of Milan-Bicocca, Milan, Italy.
Psychiatry Res. 2025 Mar;345:116371. doi: 10.1016/j.psychres.2025.116371. Epub 2025 Jan 20.
Suicide is a complex and multifactorial phenomenon, with increasing evidence highlighting the link between physical pain and suicidal thoughts and behaviors. This meta-analysis examines suicide-related outcomes among individuals with and without physical pain. We searched PubMed, PsycINFO, and Cochrane databases, including 91 studies in the review and 88 in the meta-analysis. Data were analyzed using Comprehensive Meta-Analysis software (version 3.7). The findings revealed that people experiencing physical pain were significantly more likely to have suicide-related outcomes than those without pain. The strongest associations were found for lifetime death wish (OR = 2.10), current suicidal ideation (OR = 1.93), and lifetime suicide attempts (OR = 1.94). Among adolescents, self-harm was notably higher among those with pain, while adults showed a higher risk of lifetime suicide attempts and suicide death. In older adults, suicidal ideation and suicide attempts were more strongly linked to pain. Females had higher odds of suicidal ideation compared to males. Specific painful conditions, like fibromyalgia, abdominal pain, and migraines, were also linked to increased suicide risk. Limitations include high heterogeneity and lack of data on some suicide-related outcomes. Pain is a significant risk factor for suicidality across all ages and in specific populations, as conceptualized by ideation-to-action framework suicide models.
自杀是一种复杂的多因素现象，越来越多的证据凸显了身体疼痛与自杀念头及行为之间的联系。这项荟萃分析研究了有身体疼痛和无身体疼痛个体的自杀相关结局。我们检索了PubMed、PsycINFO和Cochrane数据库，纳入综述的有91项研究，纳入荟萃分析的有88项研究。使用综合荟萃分析软件（版本3.7）对数据进行分析。研究结果显示，经历身体疼痛的人出现自杀相关结局的可能性显著高于无疼痛者。在终身死亡愿望（比值比=2.10）、当前自杀意念（比值比=1.93）和终身自杀未遂（比值比=1.94）方面发现了最强的关联。在青少年中，有疼痛者的自我伤害行为明显更多，而成年人终身自杀未遂和自杀死亡的风险更高。在老年人中，自杀意念和自杀未遂与疼痛的关联更强。女性自杀意念的几率高于男性。特定的疼痛状况，如纤维肌痛、腹痛和偏头痛，也与自杀风险增加有关。局限性包括高度异质性以及缺乏一些自杀相关结局的数据。如意念到行动框架自杀模型所概念化的那样，疼痛是所有年龄段及特定人群自杀的一个重要危险因素。
