Suicidal behavior, satisfaction with life, and perceived social support in end-stage renal disease

Suicide has been rarely studied among end-stage renal disease (ESRD) patients. The purpose of this study is to assess the frequency of suicidal thoughts, plans, and attempts among ESRD patients including the interactions among suicidal behavior, the level of social support, and satisfaction with life.

The study group, of medically stable kidney recipients, including 20 men and 20 women had a mean 121.81 +/- 72.72-months follow-up for ESRD. All patients were administered a questionnaire including demographic and clinical characteristics; specific questions about psychiatry consultations, as well as questions about suicidal thoughts, plans, and attempts before and after transplantation. Patient responses were confirmed by chart reviews; inconsistencies were clarified with the patients. Additionally, all patients completed a validated Turkish version of two self-report scales, Satisfaction with Life Scale (SLS) and Multidimensional Scale of Perceived Social Support (MSPSS).

In total, psychiatrists assessed 19 ESRD patients, including all suicidal patients. Eight patients reported "suicidal thoughts-plans," including two attempts. MSPSS results revealed that a history of psychiatric consultation (P <.05) and "suicidal thoughts-plans," (P <.05) significantly correlated with lower MSPSS scores. MSPSS scores were correlated with SLS (P <.05). Of all patients, six reported "suicidal thoughts-plans," including one suicide attempt prior to transplantation. Of six patients, one was married and five were not (P <.05). Among the three patients who reported suicidal thoughts-plans in the posttransplantation period, two, including one attempter, were new cases.

High rates of suicidal thoughts-plans and attempts were found among our ESRD patients. The probability of suicidal behavior significantly increased among recipients that were single or divorced; whose satisfaction with life was decreased; and who perceived their family, friends, and significant others to be less supportive. More detailed prospective studies on suicide are needed for better care of ESRD patients.