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Cited by 53Suicide and Self-Harm StudiesMental Health Treatment and AccessCancer survivorship and care

The DOI matches its Crossref record; 20 of the 21 references it cites were found in a registry or an index.

Risk of suicide after diagnosis of severe physical health conditions: a retrospective cohort study of 47 million people

Open access
Nafilyan, Vahé, Morgan, Jasper, Mais, David, Sleeman, Katherine E., Butt, Asim, Ward, Isobel, Tucker, James, Appleby, Louis, Glickman, Myer·2023·The Lancet Regional Health - Europe
DOI 10.1016/j.lanepe.2022.100562PMC PMC9760649
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Abstract

Background: The diagnosis of a severe physical health condition can cause psychological distress and lead to severe depression. The association between severe physical health conditions and the risk of suicide, and how the risk of suicide changes in the months following diagnosis, are not clear. Methods: We estimated whether a diagnosis of severe physical health conditions is associated with an increase in the risk of death by suicide using a dataset based on the 2011 Census linked to hospital records and death registration records covering 47,354,696 people alive on 1 January 2017 in England. Patients diagnosed with a low-survival cancer, chronic ischaemic heart disease, chronic obstructive pulmonary disease, or degenerative neurological condition were matched to individuals using socio-demographic characteristics from the Census. Using the Aalen-Johansen estimator, we estimated the cumulative incidence of death by suicide occurring between 1 January 2017 and 31 December 2021 (registered by 31 December 2021) in patients and matched controls, adjusted for other potential confounders using inverse probability weighting. Findings: Diagnosis of severe conditions was associated with an increased risk of dying by suicide. One year after diagnosis, the rate of suicide was 21.6 (95% confidence intervals: 14.9-28.4, number of events (N): 39) per 100,000 low-survival cancer patients compared to 9.5 (5.6-14.6, N:16) per 100,000 matched controls. For COPD patients, the one-year suicide rate was 22.4 (19.4-25.5, N:208) per 100,000 COPD patients (matched controls: 10.6, 8.3-13.0, N:85), for ischaemic heart disease 16.1 (14.1-18.2, N:225) per 100,000 patients (matched controls: 8.8, 7.1-10.4, N:128), for degenerative neurological conditions 114.5 (49.6-194.7, N:11) per 100,000 patients. The increase in risk was more pronounced in the first six months after diagnosis or first treatment. Interpretation: A diagnosis of severe physical illness is associated with higher suicide risk. The interaction of physical and mental illness emphasises the importance of collaborative physical and mental health care in these patients. Funding: The Office for National Statistics. KES is the Laing Galazka chair in palliative care at King's College London, funded by an endowment from Cicely Saunders International and the Kirby Laing Foundation.

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Crossref · 10.1016/j.lanepe.2022.100562

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  • For new serious illness or injury, suicidality is often present at the outset, but it does not persist over the long run.

    “For new serious illness or injury, suicidality is often present at the outset, but it does not persist over the long run (Nafilyan et al. 2023).”

    From The realities of Medical Assistance in Dying in Canada (2023) · cites this paper as Nafilyan et al. 2023

    The Discussion (Main findings; page unavailable) says suicide risk was highest immediately after diagnosis, but also reports increased risk in the second year for low-survival cancer. The Results (Risk of suicide in patients with severe physical health conditions; page unavailable) state that risk for COPD remained elevated throughout two years. The study measured deaths by suicide after severe physical illness, not suicidality after injury. (LLM, conf=0.88)

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  • There is voluminous scientific research showing the right care for serious conditions can unquestionably lead to adjustment and recovery.

    “There is voluminous scientific research showing the right care for serious conditions can unquestionably lead to adjustment and recovery.”

    From The realities of Medical Assistance in Dying in Canada (2023) · cites this paper as Nafilyan et al. 2023

    The Abstract’s Interpretation says severe physical illness is associated with higher suicide risk and emphasizes collaborative physical and mental health care. The Discussion’s Main findings concern suicide risk after diagnosis, not outcomes of care. The paper therefore supports the relevance of care, but does not establish that appropriate care leads to adjustment and recovery or that voluminous research demonstrates this unequivocally. (LLM, conf=0.78)

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1 of the 21 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. Holma, 2010, vol. 167, 801
  2. Ganzini, 2008, vol. 337
  3. Block, 2000, vol. 132, 209
  4. Fulton, 2018, vol. 21, 1024

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Metadata

Authors
Nafilyan, V., Morgan, J., Mais, D., Sleeman, K. E., Butt, A., Ward, I., Tucker, J., Appleby, L., & Glickman, M.
Affiliations
  • Office for National Statistics (GB)
  • King's College London (GB)
  • University of Manchester (GB)
Corresponding author
Nafilyan, Vahé
ORCID
Venue
The Lancet Regional Health - Europe
Publisher
Elsevier BV
Published
2023-02
Volume
25
Pages
100562
ISSN
2666-7762 (ISSN-L)
DOI
10.1016/j.lanepe.2022.100562
PMC
PMC9760649
OpenAlex
W4311452197
Cited by
53
References
21
Citations by year
2026: 17 · 2025: 14 · 2024: 16 · 2023: 6
FWCI
8.22
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Regional Health - Europe (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Bristol Research (University of Bristol) (submittedVersion, cc-by-nc-nd)
Funders
National Institute for Health and Care Research (CS-2015-15-005)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
suicide risk, cancer diagnosis, ischemic heart disease, chronic obstructive pulmonary disease, depression, psychological distress, suicide mortality, hospital readmission

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