The Association of Pain Intensity and Suicide Attempts Among Patients Initiating Pain Specialty Services

被引:16
作者
Ashrafioun, Lisham [1 ,2 ]
Kane, Cathleen [1 ]
Bishop, Todd M. [1 ,2 ]
Britton, Peter C. [1 ,2 ]
Pigeon, Wilfred R. [1 ,2 ]
机构
[1] Canandaigua VA Med Ctr, VA VISN 2 Ctr Excellence Suicide Prevent, 400 Ft Hill Ave, Canandaigua, NY 14424 USA
[2] Univ Rochester, Med Ctr, Dept Psychiat, Rochester, NY 14642 USA
关键词
Pain intensity; suicide attempts; psychiatric disorders; veterans; treatment; suicide risk; NUMERIC RATING-SCALE; PSYCHOLOGICAL DISTRESS; UNITED-STATES; RISK-FACTORS; US VETERANS; IDEATION; CARE; COHORT; PREVALENCE; DISABILITY;
D O I
10.1016/j.jpain.2019.01.012
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Using Veterans Health Administration data, we assessed the extent to which mean past-year (365 days) pain intensity scores were associated with suicide attempts in the year after the initiation of pain specialty services in fiscal years 2012 to 2014 (N = 221,817). Suicide attempts in the year after initiating Veterans Health Administration pain specialty services (ie, index visit) were identified using medical records and a suicide surveillance sources. Adjusted hazard models accounted for key covariates (eg, demographics, comorbidities). Subgroup analyses were also conducted on veterans without and with a suicide attempt in the year before the index visit to examine risk for first attempt and reattempts. Adjusted analyses revealed that pain intensity scores were significantly associated suicide attempts after the index visit. Specifically, veterans with severe and moderate pain had a hazards ratio of 1.41 (95% confidence interval = 1.21-1.63) and 1.29 (95% confidence interval = 1.13-1.47), respectively. These results were consistent for those without a past-year attempt and for those with a past-year attempt. The results suggest that moderate to severe pain intensity in the year before initiating pain specialty services may be a useful indicator of suicide risk, even when considered in the context of key factors. Perspective: This study used national administrative and suicide surveillance data to assess the relationship between pain intensity and suicide attempts after an initial visit for pain specialty services among veterans. These findings highlight the potential usefulness of assessing pain intensity as an indicator for suicide risk. (C) Published by Elsevier Inc. on behalf of the American Pain Society
引用
收藏
页码:852 / 859
页数:8
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