Cancer‐related suicide: A biopsychosocial‐existential approach to risk management

Banyasz, Alissa; Gregorio, Sharla M. Wells-Di

doi:10.1002/pon.4768

Cited by 10 publications

(10 citation statements)

References 9 publications

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“…Besides professional care, family communication and social support also play an important role in preventing suicides and suicide attempts. 1,51,52 There were some limitations in our study. Besides pathological factors, suicide was affected by psychological and social factors which could not be provided by the SEER database.…”

Section: Discussionmentioning

confidence: 91%

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Risk factors associated with suicide among kidney cancer patients: A Surveillance, Epidemiology, and End Results analysis

et al. 2019

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Background The suicide risk was higher in kidney cancer patients than in the general population. The purpose of this study was to characterize the suicide rates among kidney cancer patients and to identify the potential risk factors associated with suicide from the Surveillance, Epidemiology, and End Results (SEER) database. Methods Kidney cancer patients were identified from the SEER database during 1973‐2015. Suicide rates and standardized mortality ratios (SMRs) of this population were calculated, and the US general population during 1981‐2015 was chosen as a reference. Univariable and multivariable Cox regression were performed to find out potential risk factors of suicide. Results There were 207 suicides identified among 171 819 individuals with kidney cancer observed for 948 272 person‐years. The suicide rate was 21.83 per 100 000 person‐years, and SMR was 1.83 (95% CI: 1.59‐2.10). On Cox regression, diagnosis in early years (1973‐1982 vs 2003‐2015, HR: 2.03, 95% CI: 1.01‐4.11, P = 0.048; 1983‐1992 vs 2003‐2015, HR: 1.99, 95% CI: 1.18‐3.35, P = 0.010), male sex (vs female sex, HR: 4.43, 95% CI: 2.95‐6.65, P < 0.001), unmarried status (vs married status, HR: 2.54, 95% CI: 1.91‐3.38, P < 0.001), non‐black race (white race vs black race, HR: 4.47, 95% CI: 2.09‐9.58, P < 0.001; other races vs black race, HR: 3.01, 95% CI: 1.08‐8.37, P = 0.035), higher histologic grade (grade IV vs grade I, HR: 3.27, 95% CI: 1.50‐7.13, P = 0.003; grade III vs grade I, HR: 2.13, 95% CI: 1.19‐3.81, P = 0.011) and cancer‐directed surgery not performed (vs performed, HR: 2.78, 95% CI: 1.52‐5.11, P < 0.001) were independent risk factors of suicide among kidney cancer patients. Conclusions Diagnosis in early years, male sex, unmarried status, non‐black race, higher histologic grade, and cancer‐directed surgery not performed were significantly associated with suicide among kidney cancer patients. In order to prevent suicidal death, clinicians should pay more attention to patients with high‐risk factors of suicide.

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Section: Discussionmentioning

confidence: 91%

“…Additionally, the efforts for decreasing suicide need coordination and collaboration, including medical workers, family members even the whole society. Besides professional care, family communication and social support also play an important role in preventing suicides and suicide attempts …”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with suicide among kidney cancer patients: A Surveillance, Epidemiology, and End Results analysis

et al. 2019

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“…The rareness of suicide has led to few prevention studies, yet the international take‐up of medically assisted dying creates an opportunity to see if psychotherapeutic interventions can prevent the premature ending of life based on fear of the future and demoralization. Banyasz et al suggest that an existential perspective can substantially improve understanding and relieve suicidal ideation. Attention to caregivers and their needs should always be part of existentially oriented work …”

Section: How Do We Ameliorate Existential Distress?mentioning

confidence: 99%

Existential distress in cancer: Alleviating suffering from fundamental loss and change

2018

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A severe life threatening illness can challenge fundamental expectations about security, interrelatedness with others, justness, controllability, certainty, and hope for a long and fruitful life. That distress and suffering but also growth and mastery may arise from confrontation with an existentially threatening stressor is a longstanding idea. But only recently have researchers studied existential distress more rigorously and begun to identify its distinct impact on health care outcomes.Operationalizations of existential distress have included fear of cancer recurrence, death anxiety, demoralization, hopelessness, dignity-related distress, and the desire for hastened death. These focus in varying emphasis on fear of death, concern about autonomy, suffering, or being a burden to others; a sense of profound loneliness, pointlessness or hopelessness; grief, regret, or embitterment about what has been missed in life; and shame if dignity is lost or expectations about coping are not met.We provide an overview of conceptual issues, diagnostic approaches, and treatments to alleviate existential distress. Although the two meta-analyses featured in this special issue indicate the progress that has been made, many questions remain unresolved. We suggest how the field may move forward through defining a threshold for clinically significant existential distress, investigating its comorbidity with other psychiatric conditions, and inquiring into adjustment processes and mechanisms underlying change in existential interventions. We hope that this special issue may inspire progress in this promising area of research to improve recognition and management of a central psychological state in cancer care. KEYWORDScancer, death anxiety, demoralization, existential distress, existential suffering, existential therapy, fear of cancer recurrence, hopelessness, sense of dignity

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“…31 Providing psychological treatment to patients with leukemia at risk of depression can help to reduce the risk of suicide, as can the application of active treatment, improving their quality of life, and strengthening communication between family members. 47 Our research was subject to some limitations. We used SEER*Stat software (version 8.3.6) to collect patient information, but some information is currently missing from the system, such as the marital status, medication status, chemotherapy status, social factors, and psychological factors.…”

Section: Discussionmentioning

confidence: 98%

“…Some tools are available for identifying the risk of depression, including the Baker Depression Scale 31 . Providing psychological treatment to patients with leukemia at risk of depression can help to reduce the risk of suicide, as can the application of active treatment, improving their quality of life, and strengthening communication between family members 47 …”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with suicide among leukemia patients: A Surveillance, Epidemiology, and End Results analysis

Cai

Huang

et al. 2020

Cancer Medicine

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Previous studies have found that the risk of suicide is higher in patients diagnosed with cancer than in the general population. We aimed to identify potential risk factors associated with suicide in leukemia patients by analyzing data obtained from the Surveillance, Epidemiology, and End Results (SEER) database. We screened the SEER database for leukemia patients added between 1975 and 2017, and calculated their suicide rate and standardized mortality rate (SMR) relative to the total United States population from 1981 to 2017 as a reference. Univariate and multivariate Cox regression analyses were used to determine the risk factors for suicide in leukemia patients. We collected 142,386 leukemia patients who had been added to the SEER database from 1975 to 2017, of whom 191 patients committed suicide over an observation period of 95,397 person‐years. The suicide rate of leukemia patients was 26.41 per 100,000 person‐years, and hence the SMR of the suicided leukemia patients was 2.16 (95% confidence interval [CI] = 1.85–2.47). The univariate and multivariate Cox regression analyses showed that a high risk of suicide was associated with male sex (vs. female: hazard ratio [HR] = 4.41, 95% CI = 2.93–6.63, p < 0.001), older age at diagnosis (60–69 years vs. ≤39 years: HR = 2.60, 95% CI = 1.60–4.23, p < 0.001; 70–79 years vs. ≤39 years: HR = 2.84, 95% CI = 1.72–4.68, p < 0.001; ≥80 years vs. ≤39 years: HR = 2.94, 95% CI = 1.65–5.21, p < 0.001), white race (vs. black: HR = 6.80, 95% CI = 1.69–27.40, p = 0.007), acute myeloid leukemia (vs. lymphocytic leukemia: HR = 1.59, 95% CI = 1.09–2.33, p = 0.016), unspecified and other specified leukemia (vs. lymphocytic leukemia: HR = 2.72, 95% CI = 1.55–4.75, p < 0.001), and living in a small city (vs. large city: HR = 2.10, 95% CI = 1.23–3.60, p = 0.007). Meanwhile, being a non‐Hispanic black (vs. Hispanic: HR = 0.06, 95% CI = 0.01–0.62, p = 0.019) was a protective factor for suicide. Male sex, older age at diagnosis, white race, and acute myeloid leukemia were risk factors for suicide in leukemia patients, while being a non‐Hispanic black was a protective factor. Medical workers should, therefore, provide targeted preventive measures to leukemia patients with a high risk of suicide.

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Cancer‐related suicide: A biopsychosocial‐existential approach to risk management

Cited by 10 publications

References 9 publications

Risk factors associated with suicide among kidney cancer patients: A Surveillance, Epidemiology, and End Results analysis

Risk factors associated with suicide among kidney cancer patients: A Surveillance, Epidemiology, and End Results analysis

Existential distress in cancer: Alleviating suffering from fundamental loss and change

Risk factors associated with suicide among leukemia patients: A Surveillance, Epidemiology, and End Results analysis

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