The DOI matches its Crossref record; 46 of the 46 references it cites were found in a registry or an index.
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]
Citations
Cites
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., Filiberti, A., Flechtner, H., Fleishman, S. B., Haes, J. C. J. M. D., et al. (1993) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/85.5.365 · Cited by 16,005
Depression and Pain Comorbidity: A Literature Review
Bair, M. J., Robinson, R. L., Katon, W., & Kroenke, K. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.20.2433 · Cited by 3,463
Prevalence of and Risk Factors for Lifetime Suicide Attempts in the National Comorbidity Survey
Kessler, R. C., Borges, G., & Walters, E. E. (1999) · Archives of General Psychiatry · doi:10.1001/archpsyc.56.7.617 · Cited by 2,514
Pain and Its Treatment in Outpatients with Metastatic Cancer
Cleeland, C. S., Gonin, R., Hatfield, A. K., Edmonson, J. H., Blum, R. H., Stewart, J. A., & Pandya, K. J. (1994) · New England Journal of Medicine · doi:10.1056/nejm199403033300902 · Cited by 2,019
Depression, Hopelessness, and Desire for Hastened Death in Terminally Ill Patients With Cancer
Breitbart, W. (2000) · JAMA · doi:10.1001/jama.284.22.2907 · Cited by 1,110
Kessler, R. C. (2005) · JAMA · doi:10.1001/jama.293.20.2487 · Cited by 1,101
Desire for death in the terminally ill
Chochinov, H. M., Wilson, K. G., Enns, M. W., Mowchun, N., Lander, S., Levitt, M., & Clinch, J. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.8.1185 · Cited by 742
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The interpersonal theory of suicide.
Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010) · Psychological Review · doi:10.1037/a0018697 · Cited by 5,292
“A review by Whitlock (1986) demonstrated that more than one-third of people who die by suicide had a medical illness at the time of their death and numerous studies (listed in Table 1) have documented a relation between the presence of physical illness and suicide.”
BackgroundWalker, J., Hansen, C. H., Martin, P., Symeonides, S., Ramessur, R., Murray, G., & Sharpe, M. (2014) · The Lancet Psychiatry · doi:10.1016/s2215-0366(14)70313-x · Cited by 435
Self-citationHolland, J. C., Andersen, B. L., BREITBART, W. S., Buchmann, L. O., Compas, B. E., Deshields, T. L., Shannon-Dudley, M., Fleishman, S. B., Fulcher, C. D., Greenberg, D. B., et al. (2013) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2013.0027 · Cited by 444
Sharpe, M., Walker, J., Hansen, C. H., Martin, P., Symeonides, S., Gourley, C., Wall, L., Weller, D., & Murray, G. (2014) · The Lancet · doi:10.1016/s0140-6736(14)61231-9 · Cited by 269
Self-citationEvaluating the Older Patient with Cancer: Understanding Frailty and the Geriatric Assessment
Pal, S. K., Katheria, V., & Hurria, A. (2010) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.20059 · Cited by 258
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
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