Chronic pain and suicide

People with chronic pain other than arthritis are four times more likely to have attempted suicide than other adults, according to the results of a recent study out of the University of Michigan in Ann Arbor. Further, researchers found that pain in the head or in several different areas of the body is an indicator for suicidal tendencies. People with severe headaches are twice as likely to have thought about or attempted suicide.

Although the majority of people with chronic pain do not develop suicidal tendencies, 14% of respondents with three or more painful conditions said they had thought about suicide and almost 6% reported an actual suicide attempt. Nearly 8% of people with frequent or severe headaches had thought about killing themselves. This is four times the rate found among adults with no chronic head pain.

A study by researchers in the United States found this increased risk remained even when the possible effect of mental illness was accounted for and the researchers say it provides further evidence of the need to be aware of the heightened risk for suicide in those with chronic pain.

Lead study author Dr. Mark Ilgen, says the research shows that more work needs to be done in identifying those likely to be at the greatest risk and what interventions will decrease this risk.

The study by Dr. Ilgen and his colleagues set out to gain a perspective on the link between pain and suicide amongst the public as most research had only examined the issue in patients already receiving treatment for their pain.

Dr. Ilgen, a psychologist at the Ann Arbor VA Hospital and assistant professor at the University of Michigan, says pain is one of those factors that may make someone feel more hopeless and less optimistic about the future and increases the chances that they will think about suicide, but the vast majority of people experiencing any of these forms of pain are not suicidal.

For the study the researchers examined information collected during a 2001 to 2003 epidemiological survey of 5,692 English-speaking adults in the United States who answered questions about chronic pain and suicidal thoughts in the last 12 months.

They found after adjusting the figures to account for the effect of mental illness and chronic physical conditions, that those who suffered from head pain were almost twice as likely as others to report having suicidal thoughts and were also more than two times as likely to report suicide attempts.

The researchers also found that those with other types of pain not related to arthritis were four times as liable to have tried to commit suicide and almost 14% of those with three or more pain conditions reported suicidal thoughts - almost 6% of these also reported a suicide attempt.

Experts say people accustomed to pain might think they could tolerate suicide but the natural and deep fear of pain, injury and death stops people from hurting themselves, and this includes people who have high desire for suicide and this might not be as difficult for someone who has already had to contend with a great deal of physical pain.

This say such a view attracts little attention because in the public mind, a kind of fearlessness does not seem to fit with suicide but in this case the public mind is mistaken

 Source: General Hospital Psychiatry, November/December, 2008