Patients with cardiovascular disorders and suicidality: A systematic review and meta-analysis

Findings from this study hold considerable significance, offering invaluable data on the correlation between specific physical health conditions and suicide risk in primary or general healthcare settings-an understudied yet critical area that has implications for the efficiency, cost, and burden of widespread suicide prevention strategies.

To evaluate the suicide risks of patients with cardiovascular disorders compared to the general population, and to construct a disease-suicide risk predictive model, emphasizing the contribution of various diseases to the risk of suicide DATA SOURCES: For this study, we retrieved human research studies published up until June 2023 from PubMed, Cochrane Library, Embase, Web of Science, CINAHL, and PsycINFO, employing the search term "(((suicide) OR (self-harm) OR (suicidality)) AND ((cardiovascular diseases) OR (heart diseases)))." We also conducted searches on databases from countries referenced in the selected articles. We extracted data from existing works by Junting Chi and Dante Duarte to facilitate comparisons and ensure the compatibility of our methodology.

The preregistered systematic review and meta-analysis followed Cochrane and PRISMA guidelines. Data were extracted into standardized tables per a prespecified structured checklist, and quality scores were added. Heterogeneity was tested via I². For pooled effect estimates, we used random-effects models. The Begg and Egger tests, sensitivity analyses were performed.

Suicidal tendencies among cardiovascular disease patients from inception to the present: an examination of suicide ideation, planning, and attempts.

Of 17427 search results, 13 articles were included in the systematic review and meta-analysis. Meta-analysis showed a significantly higher suicidality in patients with cardiovascular disorders: general CVD (OR = 1.44, 95% CI 1.08-1.93; P < 0.01, I² =91.7%), CHF (OR = 1.68, 95% CI 1.56-1.81; P < 0.05, I² =60.2%), Ischemic HD (OR = 1.50, 95% CI 1.22-1.85; P < 0.01, I² =91.4%), hypertension (OR = 1.15, 95% CI 1.08-1.23, P < 0.01, I² =87.3%), dyslipidemia (OR = 0.83, 95% CI 0.75-0.92, P < 0.01, I² =82.2%), cerebrovascular disease (OR=1.84, 95% CI 1.78-1.90, P = 0.617, I² =0%). Cardiovascular disorders also showed a significantly elevated suicide mortality rate with a pooled SMR of 2.74 (95% CI: 2.19-3.43, P < 0.01, I² =98.1%). In our further meta-analysis investigating suicide risk in 16 diseases including cardiovascular ones, a model was developed assigning each disease a score. Results indicated that, despite cardiovascular diseases' risk impact, mood disorders, substance abuse disorders, and depression were more significant contributors.

This study, through a meta-analysis, reveals a link between cardiovascular disorders and increased suicide rates, making these patients primary targets for suicide prevention. And we've developed a model highlighting the contribution of multiple diseases, not just cardiovascular, to suicide risk.