Suicide Among Persons with Back Pain A Population-Based Study of 2310 Suicide Victims in Northern Finland

Study Design: A population-based study of suicides and linkage with national hospital discharge registers. Objective: To investigate the prevalence of hospital-treated musculoskeletal diseases, particularly back pain (BP), among suicide victims to compare suicide characteristics between victims with and without musculoskeletal diseases, to analyze comorbidity between musculoskeletal diseases and psychiatric disorders, and to evaluate whether specific drugs have a role in suicides by poisoning. Summary of Background Data: Depression, other psychiatric disorders, and suicidal behavior are common comorbid conditions in patients with diseases of the musculoskeletal system. Methods: The data consisted of 2310 suicides (1885 men and 425 women) committed in the province of Oulu in Northern Finland during 1988 to 2007. The information on hospital-treated musculoskeletal diseases (MSD) was extracted from the Finnish Hospital Discharge Registers. The suicide victims with a diagnosis of BP, including sciatica (BP, n = 133), and victims with MSD other than BP/MSD, n = 357) were compared with those of having no history of MSD (reference group, n = 1820). The data on suicides were based on death certificates that were taken from official medicolegal investigations. Results: A total of 490 (21.3%) of suicide victims had a history of hospital-treated MSD. The age of death of the victims with BP was about 11 years higher compared with the reference group. After adjusting for age, nonviolent suicide methods and use of analgesics in poisoning suicides in both genders and hospital-treated depression/substance-related disorders in men were also more common in the BP and MSD groups. Women with BP had been more often under the influence of alcohol when committing suicide compared with the other groups. Conclusion: Victims with a history of hospital-treated MSD committed suicide at older age. However, the older the person is, the more is the chance that he or she needs to have a treatment for some MSD at some point of life. Use of analgesics as a potential suicide method should be kept in mind when treating patients with musculoskeletal system diseases.