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Better Off Dead: Suicidal Thoughts in Cancer Patients
Abstract
Purpose: Cancer is associated with an increased risk of suicide and attempted suicide. However, we do not know how many cancer patients have thoughts that they would be better off dead or thoughts of hurting themselves. This study aimed to determine the prevalence of such thoughts in cancer outpatients and which patients are most likely to have them. Patients and Methods: A survey of consecutive patients who attended the outpatient clinics of a regional cancer center in Edinburgh, United Kingdom. Patients completed the Patient Health Questionnaire-9 (PHQ-9), which included Item 9 that asks patients if they have had thoughts of being better off dead or of hurting themselves in some way in the previous 2 weeks. Those who reported having had such thoughts for at least several days in this period were labeled as positive responders. Patients also completed the Hospital Anxiety and Depression Scale (HADS) and a pain scale. The participating patients’ cancer diagnoses and treatments were obtained from the cancer center clinical database. Results: Data were available on 2,924 patients; 7.8% (229 of 2,924; 95% CI, 6.9% to 8.9%) were positive responders. Clinically significant emotional distress, substantial pain, and—to a lesser extent—older age, were associated with a positive response. There was strong evidence of interactions between these effects, and emotional distress played the most important role. Conclusion: A substantial number of cancer outpatients report thoughts that they would be better off dead or thoughts of hurting themselves. Management of emotional distress and pain should be a central aspect of cancer care.
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“Concurrently, they are associated with an increased risk of depression,2829 and sadness is a core symptom of depression.12”
From Prevalence and Correlates of Suicidal Ideation among Psycho-Oncology Outpatients (2024) · cites this paper as [12]
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Metadata
- Authors
- Walker, J., Waters, R. A., Murray, G., Swanson, H., Hibberd, C. J., Rush, R. W., Storey, D. J., Strong, V. A., Fallon, M. T., Wall, L. R., & Sharpe, M.
- Affiliations
- Edinburgh Cancer Research (GB)
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2008-10-10
- Volume
- 26
- Issue
- 29
- Pages
- 4725-4730
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2015182459
- Cited by
- 195
- References
- 46
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 9 · 2023: 7 · 2022: 20 · 2021: 13 · 2020: 16 · 2019: 10 · 2018: 12 · 2017: 9 · 2016: 7 · 2015: 8 · 2014: 12 · 2013: 15 · 2012: 7
- FWCI
- 15.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Queen Margaret University Publications Repository (Queen Margaret University) (acceptedVersion)
- Queen Margaret University Publications Repository (Queen Margaret University) (submittedVersion)
- Funders
- Cancer Research UK
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- suicidal ideation, cancer patients, suicide risk, emotional distress, pain, depression, anxiety, cancer outpatients, prevalence, risk factors, cancer care
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Attitude to Death, Cross-Sectional Studies, Female, United Kingdom, Humans, Male, Middle Aged, Neoplasms, Outpatients, Suicide, Thinking, Prevalence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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