The association of pain with suicidal ideation and suicide attempts with depressive symptoms among adults aged ≥50 years from low‐ and middle‐income countries

Abstract

Objectives We aimed to examine the relationship of pain with suicidal ideation and suicide attempts with depressive symptoms among adults aged ≥50 years from six low‐ and middle‐income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa). Methods Cross‐sectional, community‐based, nationally representative data from the WHO Study on global AGEing and adult health were analyzed. Self‐reported information on past 12‐month suicidal ideation and suicide attempts among people with depressive symptoms was collected. Pain was assessed with the question “Overall in the last 30 days, how much of bodily aches or pain did you have?” With answer options: “none”, “mild”, “moderate”, “severe/extreme”. Multivariable logistic regression was done to assess associations. Results Data on 34,129 adults aged ≥50 years (mean [SD] age 62.4 [16.0] years; males 47.9%) were analyzed. Compared to no pain, mild, moderate, and severe/extreme pain were associated with 2.83 (95% CI = 1.51–5.28), 4.01 (95% CI = 2.38–6.76), and 12.26 (95% CI = 6.44–23.36) times higher odds for suicidal ideation. For suicide attempt, only severe/extreme pain was associated with significantly increased odds (OR = 4.68; 95% CI = 1.67–13.08). Conclusions In this large sample of older adults from multiple LMICs, pain was strongly associated with suicidal thoughts and suicide attempts with depressive symptoms. Future studies should assess whether addressing pain among older people in LMICs may lead to reduction in suicidal thoughts and behaviors.

Depressive symptoms and all-cause mortality among middle-aged and older people in China and associations with chronic diseases

“…Numerous studies have found that compared to other depressed populations (e.g., adolescents), middle-aged adults have more persistent ( 51 ) and severe depressive symptoms ( 52 ), are more difficult to treat ( 53 ), and have depression for a longer period ( 54 , 55 ). This means that most middle-aged adults with depressive symptoms are more likely to develop depression ( 7 ) and that, over time, depressive symptoms will have a greater impact on their physical health ( 52 ), leading to more serious physical illnesses ( 56 ), and may also coexist with chronic illnesses ( 57 ), which may worsen the progression of these illnesses ( 58 , 59 ), increase the risk of self-inflicted suicide ( 60 ), and increase the risk of death ( 61 ). As China is about to enter an aging society, middle-aged and older people will account for an increasing proportion of the current and future Chinese population ( 62 ), with an estimated 500 million people over 80 by 2050 ( 63 ).…”