Pain associated with elevated suicide risk in veterans

Image: PD

1. Veterans with back pain, psychogenic pain, or migraine were more likely to commit suicide than veterans without those conditions. 

2. Compared to a single pain condition, having multiple pain conditions did not increase risk of suicide. 

Evidence Rating Level: 2 (Good) 

Study Rundown: This study found that veterans suffering from chronic back pain, psychogenic pain or migraine were more likely to commit suicide. Given that nearly 25% of veterans studied had one of these three conditions, these results highlight the need for providers to evaluate suicide risk in veterans affected by pain management issues. Strengths of the study include a large sample size (n=4,863,063) and control for psychiatric conditions. Though, study generalizability may be limited by a predominantly male (91.7%) population. Additionally, the authors’ inability to control for race/ethnicity, employment status, and social support networks may mask bias. Future research might employ a prospective design, enroll a more nationally representative population and collect information on the demographic factors missing in this study.

Click to read the study in JAMA Psychiatry

Relevant Reading: Severe pain predicts greater likelihood of subsequent suicide

In-Depth [retrospective cohort study]: This study examined the relationship between pain conditions and suicide risk in a national cohort of 4,863,086 Veterans Health Administration patients (ages ≥18). Eligible veterans were treated in fiscal year 2005 and alive when fiscal year 2006 began. Data obtained from patient records included suicide mortality (fiscal years 2006-2008) and diagnoses of back pain, arthritis, migraines, headache or tension headache, psychogenic pain, neuropathy, and fibromyalgia (fiscal years 2004-2005).

Overall, 0.01% of the cohort (4,823 patients) died from suicide in the 3-year study period. When controlling for concomitant psychiatric conditions, back pain (p<0.001), psychogenic pain (p<0.001) and migraine (p=0.005) were associated with elevated suicide risk. Veterans with ≥2 pain conditions were at no greater suicide risk than patients with 0-1 pain conditions. Those who committed suicide primarily used firearms (67.9%) or poison (16.6%).

By Caroline Huang and Leah Hawkins

More from this author: Brain injuries linked with increased military suicide risk, Ethnic disparities in HPV 16/18-positive high-grade cervical lesions, Exercise program does not reduce depression in the elderly, Integrated 2D/3D mammography improves breast cancer detection, One third of breast cancer survivors report pain 5-7 years after treatment

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain.