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Cancer-related pain and suicidal ideation in psychiatric outpatients with cancer: a cross-sectional study
Alessio Simonetti1, Davide Tripaldella2, Francesca Bardi2
1Department of Neurosciences, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Objective:
To investigate the associations of pain severity and pain interference with both severity and intensity of suicidal ideation in a cohort of psychiatric outpatients with cancer.
Methods:
Psychiatric outpatients with cancer (n = 492) underwent a multidisciplinary assessment, including the Columbia-Suicide Severity Rating Scale (C-SSRS) to assess suicidal ideation severity and intensity, and the Brief Pain Inventory (BPI) to assess pain severity and pain interference. Additional validated measures were administered to assess depressive, anxiety, and manic symptoms. Univariate linear regression analyses were conducted to identify sociodemographic and clinical variables associated with suicidal ideation severity and intensity. Four multivariable linear regression models were then performed to investigate the association between pain and suicidal ideation dimensions, adjusting for significant covariates.
Results:
In univariate analyses, family history of suicide, longer oncological illness, greater previous depressive episodes, greater depressive and manic symptomatology, and gastrointestinal cancer type were significantly associated with both suicidal ideation severity and intensity. In multivariable analyses, both pain severity and pain interference remained significantly associated with greater suicidal ideation intensity (pain severity: β = 0.32, p < 0.001; pain interference: β = 0.32, p < 0.001) and severity (pain severity: β = 0.10, p < 0.001; pain interference: β = 0.10, p < 0.001).
Conclusions:
These findings suggest that both the intensity of cancer-related pain and its impact on daily functioning are associated with suicidal ideation even after adjustment for major clinical and psychiatric covariates. Systematic pain assessment, coupled with targeted evaluation of suicide risk when needed, may help identify individuals requiring timely multidisciplinary care.
