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Cited by 238Suicide and Self-Harm StudiesOpioid Use Disorder TreatmentMusculoskeletal pain and rehabilitation

Noncancer pain conditions and risk of suicide

Ilgen, Mark A., Kleinberg, Felicia, Ignacio, Rosalinda V., Bohnert, Amy S. B., Valenstein, Marcia, McCarthy, John F., Blow, Frederic C., Katz, Ira R.·2013·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2013.908
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Abstract

IMPORTANCE: There are limited data on the extent to which suicide mortality is associated with specific pain conditions. OBJECTIVE: To examine the associations between clinical diagnoses of noncancer pain conditions and suicide among individuals receiving services in the Department of Veterans Affairs Healthcare System. DESIGN: Retrospective data analysis. SETTING: Data were extracted from National Death Index and treatment records from the Department of Veterans Healthcare System. PARTICIPANTS: Individuals receiving services in fiscal year 2005 who remained alive at the start of fiscal year 2006 (N = 4 863 086). MAIN OUTCOMES AND MEASURES: Analyses examined the association between baseline clinical diagnoses of pain-related conditions (arthritis, back pain, migraine, neuropathy, headache or tension headache, fibromyalgia, and psychogenic pain) and subsequent suicide death (assessed in fiscal years 2006-2008). RESULTS: Controlling for demographic and contextual factors (age, sex, and Charlson score), elevated suicide risks were observed for each pain condition except arthritis and neuropathy (hazard ratios ranging from 1.33 [99% CI, 1.22-1.45] for back pain to 2.61 [1.82-3.74] for psychogenic pain). When analyses controlled for concomitant psychiatric conditions, the associations between pain conditions and suicide death were reduced; however, significant associations remained for back pain (hazard ratio, 1.13 [99% CI, 1.03-1.24]), migraine (1.34 [1.02-1.77]), and psychogenic pain (1.58 [1.11-2.26]). CONCLUSIONS AND RELEVANCE: There is a need for increased awareness of suicide risk in individuals with certain noncancer pain diagnoses, in particular back pain, migraine, and psychogenic pain.

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  • Compared with males, females show greater sensitivity to pain-induced muscle reflexes, greater pupil dilation, and amplified cerebral activation in response to pain.

    “Compared with males, females demonstrate increased sensitivity to pain-induced muscle reflexes 165 and show increased pupil dilation 166 as well as amplified cerebral activation in response to pain 167.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [166]

  • Recent research indicates that most individual physical health conditions and multimorbidity of physical health conditions are associated with increased suicide risk, even after adjustment for mental health conditions.

    “Recent research also indicates that most individual physical health conditions as well as multimorbidity of physical health conditions, are associated with increased risk for suicide, even after adjustment for mental health conditions, which supports greater need for outreach to individuals receiving care in general medical settings.30,34,35”

    From Variation in patterns of health care before suicide: a population case-control study. (2019) · cites this paper as [34]

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Authors
Ilgen, M. A., Kleinberg, F., Ignacio, R. V., Bohnert, A. S. B., Valenstein, M., McCarthy, J. F., Blow, F. C., & Katz, I. R.
Affiliations
  • University of Michigan (US)
  • United States Department of Veterans Affairs (US)
Corresponding author
Ilgen, Mark A.
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2013-07-01
Volume
70
Issue
7
Pages
692
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2013.908
OpenAlex
W2147576112
Cited by
238
References
40
Citations by year
2026: 11 · 2025: 13 · 2024: 20 · 2023: 15 · 2022: 14 · 2021: 21 · 2020: 22 · 2019: 25 · 2018: 23 · 2017: 17 · 2016: 14 · 2015: 22 · 2014: 17 · 2013: 4
FWCI
21.11
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
suicide, non-cancer pain, back pain, migraine, psychogenic pain, fibromyalgia, tension-type headache, neuropathy, arthritis, suicide risk, veterans, psychiatric comorbidity
MeSH terms
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Pain, Retrospective Studies, Risk Factors, Suicide, United States, United States Department of Veterans Affairs, Veterans, Proportional Hazards Models

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