Risk of suicide after diagnosis of severe physical health conditions: a retrospective cohort study of 47 million people

Nafilyan, Vahé; Morgan, Jasper; Mais, David; Sleeman, Katherine E; Butt, Asim; Ward, Isobel; Tucker, James D.; Appleby, Louis; Glickman, Myer

doi:10.1016/j.lanepe.2022.100562

Cited by 16 publications

(11 citation statements)

References 19 publications

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“…Our findings show people whose day-to-day activities are limited either a lot or a little, relative to those who are not limited, had higher rates of suicide. Some research has found that severe health conditions are associated with a higher risk of suicide [10], [11].…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic inequalities of suicide: a population-based cohort study of adults in England and Wales 2011-2021

Ward

Finning

Ayoubkhani

et al. 2023

Preprint

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Background: Risk of suicide is complex and often a result of multiple interacting factors. It is vital research identifies predictors of suicide to provide a strong evidence base for targeted interventions. Methods: Using linked Census and population level mortality data we estimated rates of suicide across different groups in England and Wales and examine which factors are independently associated with the risk of suicide. Findings: The highest rates of suicide were amongst those who reported an impairment affecting their day-to-day activities, those who were long term unemployed or never had worked, or those who were single or separated. Rates of suicide were highest in the White and Mixed/multiple ethnic groups compared to other ethnicities, and in people who reported a religious affiliation compared with those who had no religion. Comparison of minimally adjusted models (predictor, sex and age) with fully-adjusted models (sex, age, ethnicity, region, partnership status, religious affiliation, day-to-day impairments, armed forces membership and socioeconomic status) identified key predictors which remain important risk factors after accounting for other characteristics; day-to-day impairments were still found to increase the incidence of suicide relative to those whose activities were not impaired after adjusting for employment status. Overall, rates of suicide were higher in men compared to females across all ages, with the highest rates in 40-to-50-year-olds. Interpretation: The findings of this work provide novel population level insights into the risk of suicide by sociodemographic characteristics. Understanding the interaction between key risk factors for suicide has important implications for national suicide prevention strategies.

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Section: Discussionmentioning

confidence: 99%

Sociodemographic inequalities of suicide: a population-based cohort study of adults in England and Wales 2011-2021

Ward

Finning

Ayoubkhani

et al. 2023

Preprint

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“…More than 61 million people worldwide experience serious health-related suffering that could be relieved with palliative care (PC) 1 —a person- and family-centered approach to alleviating physical, psychological, social, and spiritual distress. Nafilyan and colleagues 2 found an association between severe physical health condition diagnosis and higher suicide risk that underscores the well-established need for PC access as a component of universal health coverage. 3 PC integration is recommended at the time of serious illness diagnosis in conjunction with curative treatment to optimize quality of life outcomes.…”

mentioning

confidence: 93%

“…Nafilyan et al. 2 call for combined physical and mental health support. However, there are several PC implications to consider ( Panel ).…”

mentioning

confidence: 99%

Palliative care access: a matter of life and death

Rosa

McDarby

Chochinov

2023

The Lancet Regional Health - Europe

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“…7 Suicide rates have been shown to be more than twice as high in patients with severe physical health conditions compared with similar patients with none of these conditions. 8 Barriers and challenges to address depression at the end of life include a lack of a standardized method for assessment and diagnosis, leading to inadequate detection and insufficient treatment of depression. 9 Common physical symptoms associated with illness used to diagnose depression can be associated with a false-positive diagnosis and include sleep disturbances, loss of appetite, inability to concentrate, and increasing fatigue.…”

Section: Introductionmentioning

confidence: 99%

“…As much as 50% of terminally ill patients have a desire to die, which can include accepting death, desiring that death would come earlier than expected, desiring a hastened death, requesting assisted death, and having suicidal ideation 7 . Suicide rates have been shown to be more than twice as high in patients with severe physical health conditions compared with similar patients with none of these conditions 8 …”

mentioning

confidence: 99%

A Standard Practice Protocol for Addressing Depression in a Hospice Setting

Williams,

Cormack

2023

J Hosp Palliat Nurs

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Depression can worsen physical suffering and psychiatric distresses in individuals with life-limiting illnesses and is associated with increased rates of pain, fatigue, dyspnea, and worse survival outcomes. Evidence supports protocol development to address depression in the hospice setting using validated screening tools and a process for referral and treatment. After protocol development and integration of validated screening tools into the electronic medical record, newly admitted patients meeting inclusion criteria were screened during the social workers' initial psychosocial assessment. Patients were referred for pharmacological and nonpharmacological treatment strategies based on the severity of depression detailed in the protocol. Of all patients who met inclusion criteria, 100% were screened using the Patient Health Questionnaire-2 with 52% being identified as having some severity of depression, 26% being appropriately referred for treatment, and 50% receiving a pharmacological strategy, whereas 26% received nonpharmacological strategies. There was a statistically significant difference in severity of depression found between those identified as having a depressed mood preintervention and those with some severity of depression using a validated screening tool postintervention. Implementing a standardized practice protocol to address depression in a hospice setting allowed for consistent evaluation through the use of validated screening tool(s) and increased recognition of those with symptoms of depression.

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Risk of suicide after diagnosis of severe physical health conditions: a retrospective cohort study of 47 million people

Cited by 16 publications

References 19 publications

Sociodemographic inequalities of suicide: a population-based cohort study of adults in England and Wales 2011-2021

Sociodemographic inequalities of suicide: a population-based cohort study of adults in England and Wales 2011-2021

Palliative care access: a matter of life and death

A Standard Practice Protocol for Addressing Depression in a Hospice Setting

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