The role of physical and mental multimorbidity in suicidal thoughts and behaviours in a Scottish population cohort study

Abstract

BackgroundPhysical illness and mental disorders play a significant role in fatal and non-fatal suicidal behaviour. However, there is no clear evidence for the effect of physical and mental illness co-occurrence (multimorbidity) in suicidal ideation and attempts. The aim of the current study was to investigate, whether physical/mental health multimorbidity predicted suicidal thoughts and behaviours as outcomes.MethodsData from the West of Scotland Twenty-07 cohort were analysed. Twenty-07 is a multiple cohort study following people for 20 years, through five waves of data collection. Participants who responded to past-year suicidal thoughts and suicide attempt items were grouped into four distinct health-groups based on having: (1) neither physical nor mental health condition (controls); (2) one or more physical health condition; (3) one or more mental health condition and; (4) multimorbidity. The role of multimorbidity in predicting suicidal ideation and suicide attempts was tested with a generalised estimating equation (GEE) model and odds ratios (ORs) and 95% CIs are presented. Whether the effect of multimorbidity was stronger than either health condition alone was also assessed.ResultsMultimorbidity had a significant effect on suicidal thoughts and suicide attempts, compared to the control group, but was not found to increase the risk of either suicide-related outcomes, more than mental illness alone.ConclusionsWe identified an effect of physical/mental multimorbidity on risk of suicidal thoughts and suicide attempts. Considering that suicide and related behaviour are rare events, future studies should employ a prospective design on the role of multimorbidity in suicidality, employing larger datasets.Electronic supplementary materialThe online version of this article (10.1186/s12888-019-2032-8) contains supplementary material, which is available to authorized users.

Physical Functioning, Depressive Symptoms, and Suicidal Ideation among Older Korean Adults

“…The results of the present study showed that older adults with limited physical functioning had a higher rate of depressive symptoms and suicidal ideation. This result is consistent with previous studies which show that suicidal ideation and behaviors increase if someone has a particular physical condition [19,20].…”

“…Many studies suggest that the majority of those with physical illness have additional psychiatric disorders [2,[11][12][13][14]19]. A previous study found that the risk of suicide increases if someone has a mental illness along with a physical illness [19]. The results of the present study showed that older adults with limited physical functioning had a higher rate of depressive symptoms and suicidal ideation.…”

“…Many studies suggest that the majority of those with physical illness have additional psychiatric disorders [2,[11][12][13][14]19]. A previous study found that the risk of suicide increases if someone has a mental illness along with a physical illness [19].…”

The prevalence of multimorbidity and its association with physical activity and sleep duration in middle aged and elderly adults: a longitudinal analysis from China

“…In China, multimorbidity is common among middle-aged and older adults, with a prevalence of nearly 50% [ 5 , 6 ]. Compared with single chronic conditions, multimorbidity has been associated with more outpatient visits, longer hospital stays, increased health care costs [ 7 , 8 ], more mental complaints or disorders [ 9 , 10 ], lower quality of life [ 11 ], and increased risk of mortality [ 12 , 13 ]. Accordingly, preventing the rising prevalence of multimorbidity has become an important clinical and public health challenge in China as well as other countries.…”

Does physical ill-health increase the risk of suicide? A census-based follow-up study of over 1 million people

“…However, these studies are based on small, nonrepresentative samples of the population, including a sample limited to armed forces veterans (Scott et al, 2010;Thompson et al, 2014). Studies exploring physical health conditions co-occurring with mental health conditions have similarly suggested an increased likelihood of suicidal thoughts and behaviours but not above the independent risk of mental ill-health alone (Kavalidou et al, 2017(Kavalidou et al, , 2019. However, this may not translate into an actual risk of suicide as the epidemiology of suicide ideators or attempters differs from that of suicide completers (O'Connor and Kirtley, 2018).…”