What is the role of physical illness in the development of suicidal behaviors?

Updated: Sep 25, 2018
  • Author: Stephen Soreff, MD; Chief Editor: Glen L Xiong, MD  more...
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Answer

Answer

Suicide is often encountered in patients who have a severe medical problem. The risk for suicide increases in the face of a protracted, painful, progressively debilitating disease.

For example, patients undergoing dialysis for end-stage renal disease have a higher rate of suicide than that of the general population. [48] Other diseases conferring a higher suicide risk include chronic obstructive pulmonary disease (COPD), cancer, human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS), quadriplegia, multiple sclerosis, severe whole-body burns, and chronic heart failure.

A study by Webb et al found a significant link between physical illnesses and suicidal behavior in primary care patients. Coronary heart disease, stroke, chronic obstructive pulmonary disease, and osteoporosis were linked with increased suicide risk among all patients. Elevated risk of suicide was due to clinical depression in all patients, excluding those with osteoporosis.

However, 2 groups of women in the study—those younger than 50 years who were physically ill and older women with multiple physical diseases—were found to have an elevated suicide risk even after depression had been adjusted for. [49]

Asthma has also been linked to suicide, particularly in young people. [50, 51] The combination of cancer and age is particularly lethal. [52] Persons experiencing increasing intractable pain are at particularly high risk for suicide.

There is a possible link to suicide in patients with migraine and fibromyalgia. Researchers examined a population of patients with migraine and found that those who also had a diagnosis of fibromyalgia (FM) had a high instance of suicide ideation and attempts. [53]


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