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Ilgen MA, Zivin K, McCammon RJ, Valenstein M. Pain and suicidal thoughts, plans and attempts in the United States. General hospital psychiatry. 2008 Nov 1; 30(6):521-7.
OBJECTIVE: This study examined the association between pain and suicidality in the general US population. METHOD: Using data from the National Comorbidity Survey-Replication, we assessed relationships between four measures of pain (back and neck, headache, other nonarthritic pain and a summary score of the count of these conditions) and 12-month suicidal thoughts, plans and attempts using chi-square tests and logistic regression models. Multivariate logistic regression models controlled for demographic characteristics, chronic health conditions, mood, anxiety and substance use disorders. RESULTS: In multivariate models adjusting for concurrent psychiatric disorders and other chronic medical conditions, suicidal ideation was associated with head pain (OR 1.9, 95% CI: 1.2, 3.0) and the pain summary score (OR 1.2, 95% CI: 1.0, 1.4). Suicide attempt was also associated with head pain (OR 2.3, 95% CI: 1.2, 4.4) and pain summary score (OR 1.7, 95% CI: 1.1, 2.6). Other nonarthritic pain was associated with suicide attempts (OR4.0, 95% CI: 1.8, 9.1). CONCLUSIONS: These findings highlight the importance of pain as a potentially independent risk factor for suicide, particularly among those with head pain or multiple forms of co-occurring pain. Individuals suffering from chronic pain may be particularly appropriate for suicide screening and intervention efforts.