“Suicidal ideation is prevalent among adults with arthritis and should be carefully evaluated by physicians,” advise the authors of the report in Arthritis Care & Research online June 13.
As a chronic condition associated with pain, arthritis may increase the likelihood of suicidal thoughts, note Dr. Maria Tektonidou, with the National University of Athens, Greece, and colleagues. However, the association between arthritis and suicidal ideation is poorly characterized, and it is not known if subgroups of patients with arthritis are at greater risk.
To investigate, the team analyzed data on US adults aged 40 and older with arthritis who participated in the 2007-2008 National Health and Nutrition Examination Survey (NHANES).
Suicidal ideation was assessed based on response to the NHANES question, “Over the last two weeks how often have you been bothered by the following problem: thoughts that you would be better off dead, or of hurting yourself in someway?” While the question does not ask specifically about thoughts of attempting suicide, it has been used by many studies assessing suicidal ideation, the authors comment, and it is less likely to lead to non-response than a more specific question.
Suicidal ideation was present in 2.4% of people without arthritis compared with 5.6% of people with arthritis, the researchers found. The prevalence was similar to that among people with diabetes (6.8%) and cancer (5.1%).
Among the individuals with arthritis, those with suicidal thoughts were more likely non-white, had lower education levels, were poorer, and had higher frequency of mental health care visits, current smoking, binge drinking, anxiety and pain. They also had more comorbidities, sleep disturbances, depression, and limitations in activities of daily living, according to the report.
On the other hand, suicidal ideation was generally lower among those with longer duration of arthritis, older age, higher income, more close friends, more frequent light drinking, and more education.
The researchers found that 11 of the top 16 correlates of suicidal ideation in patients with arthritis also applied to patients with diabetes and cancer.
Summing up, Dr. Tektonidou and colleagues conclude, “Depression and short duration of arthritis, binge drinking, income, and the presence of more than three comorbidities identified subgroups at greatest risk for suicidal ideation that should be the focus of prevention and intervention approaches.”
Suicidal ideation among adults with arthritis: Prevalence and subgroups at highest risk
Arthritis Care Res 2011.