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Factors associated with suicidal ideation among patients with inflammatory rheumatic and musculoskeletal diseases: A
U Kiltz1, E von Schlichting2, J Dieris-Hirche3
1Ruhr-Universität Bochum, Universitätsstr. 105, Bochum, Germany; Rheumazentrum Ruhrgebiet, Claudiusstr. 45, Herne, Germany.
Objectives:
We aim to evaluate the prevalence of suicidal ideation and to explore factors associated with suicidal ideation in patients with inflammatory rheumatic and musculoskeletal diseases (iRMD).
Methods:
Patients with iRMD with suicidal ideation were identified in an observational cohort as cases through the PHQ-9 and were age, gender and disease-matched (1:3) with iRMD patients without suicidal ideations as controls. Patients and disease characteristics as well as risk factors for possibly committing suicide were evaluated in all patients. A standardized clinical interview was conducted by a psychosomatic expert in cases. Factors associated with suicidal ideation were investigated using logistic regression analysis.
Results:
In total, 95 patients out of 2,960 (3.2%) iRMD patients presented with suicidal ideation. Fifty cases and 150 controls agreed to participate. In cases, patient reported outcome and disease severity was substantially higher compared to controls. Cases were less satisfied with their lives and less optimistic compared to controls. Cases experienced a history of abuse and reported feelings of help- and hopelessness more often compared to controls. Additionally, cases had more often psychiatric disorders than controls. The most frequent psychiatric disorders in cases were affective disorders (80%), somatic stress disorders (64%) and trauma-related disorders (36%). Short disease duration, the presence of a somatoform syndrome, higher impulsivity, and a neurotic personality were associated with suicidal ideation.
Conclusion:
A substantial number of patients reported suicidal ideation. Cases were identified by factors associated with suicide in the general population whereas disease-specific factors did not differentiate between cases and controls. Short disease duration, the presence of a somatoform syndrome, higher impulsivity, and neuroticism were associated with suicidal ideation. Larger-scaled studies would be instrumental in unraveling factors of suicidal ideation.
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