Mental Defeat Predicts Increased Suicide Risk in Chronic Pain: A 12-Month Prospective Study

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-01-14 DOI:10.1002/ejp.4779

Kristy Themelis, Jenna L. Gillett, Paige Karadag, Martin D. Cheatle, Mark A. Ilgen, Shyam Balasubramanian, Swaran P. Singh, Nicole K. Y. Tang

{"title":"Mental Defeat Predicts Increased Suicide Risk in Chronic Pain: A 12-Month Prospective Study","authors":"Kristy Themelis, Jenna L. Gillett, Paige Karadag, Martin D. Cheatle, Mark A. Ilgen, Shyam Balasubramanian, Swaran P. Singh, Nicole K. Y. Tang","doi":"10.1002/ejp.4779","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Mental defeat is considered a potential risk factor for suicidal thoughts and behaviours in chronic pain. This study evaluated the role of mental defeat in predicting future suicide risk and examined whether depression influences this relationship.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A total of 340 participants with chronic pain completed questionnaires at two time points, 12 months apart. Data collected included sociodemographic and pain characteristics, mental defeat, psychosocial risk factors including depression and health-related variables. Weighted univariate and multivariable analyses assessed the link between mental defeat and suicide risk, with a moderation analysis testing the role of depression.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Higher levels of mental defeat and depression were linked to increased suicide risk at 12 months. Depression significantly amplified the effect of mental defeat on suicide risk, particularly in individuals with higher depression levels (<i>B</i> = 0.06, SE = 0.01, <i>t</i> = 6.21, <i>p</i> < 0.001) compared with moderate (<i>B</i> = 0.05, SE = 0.01, <i>t</i> = 5.20, <i>p</i> < 0.001) or low levels of depression (<i>B</i> = 0.04, SE = 0.01, <i>t</i> = 2.83, <i>p</i> = 0.004), indicating a dose–response relationship.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Mental defeat is a significant risk factor for suicide in chronic pain, with depression intensifying this risk. Addressing both mental defeat and depression simultaneously in treatment may help reduce suicide risk in these patients.</p>\n </section>\n \n <section>\n \n <h3> Significance</h3>\n \n <p>This study strengthens the evidence linking mental defeat with heightened suicide risk in chronic pain. By providing prospective data, it clarifies the temporality of this relationship. Given that suicide risk doubles in chronic pain patients, whereby comorbid depression is common, these findings have crucial clinical implications. Both mental defeat and depression are modifiable. Addressing them together in treatment may help reduce suicide risk in this population.</p>\n </section>\n </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 2","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733026/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Pain","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ejp.4779","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Mental defeat is considered a potential risk factor for suicidal thoughts and behaviours in chronic pain. This study evaluated the role of mental defeat in predicting future suicide risk and examined whether depression influences this relationship.

Methods

A total of 340 participants with chronic pain completed questionnaires at two time points, 12 months apart. Data collected included sociodemographic and pain characteristics, mental defeat, psychosocial risk factors including depression and health-related variables. Weighted univariate and multivariable analyses assessed the link between mental defeat and suicide risk, with a moderation analysis testing the role of depression.

Results

Higher levels of mental defeat and depression were linked to increased suicide risk at 12 months. Depression significantly amplified the effect of mental defeat on suicide risk, particularly in individuals with higher depression levels (B = 0.06, SE = 0.01, t = 6.21, p < 0.001) compared with moderate (B = 0.05, SE = 0.01, t = 5.20, p < 0.001) or low levels of depression (B = 0.04, SE = 0.01, t = 2.83, p = 0.004), indicating a dose–response relationship.

Conclusions

Mental defeat is a significant risk factor for suicide in chronic pain, with depression intensifying this risk. Addressing both mental defeat and depression simultaneously in treatment may help reduce suicide risk in these patients.

Significance

This study strengthens the evidence linking mental defeat with heightened suicide risk in chronic pain. By providing prospective data, it clarifies the temporality of this relationship. Given that suicide risk doubles in chronic pain patients, whereby comorbid depression is common, these findings have crucial clinical implications. Both mental defeat and depression are modifiable. Addressing them together in treatment may help reduce suicide risk in this population.

查看原文本刊更多论文

心理失败预示慢性疼痛患者自杀风险增加：一项为期12个月的前瞻性研究。

背景：心理失败被认为是慢性疼痛患者产生自杀念头和行为的潜在危险因素。这项研究评估了心理失败在预测未来自杀风险方面的作用，并研究了抑郁症是否会影响这种关系。方法：340名慢性疼痛患者分别在相隔12个月的两个时间点完成问卷调查。收集的数据包括社会人口学和疼痛特征、心理失败、包括抑郁和健康相关变量在内的社会心理风险因素。加权单变量和多变量分析评估了心理失败和自杀风险之间的联系，并进行了适度分析，测试了抑郁的作用。结果：在12个月内，心理挫败和抑郁程度越高，自杀风险越高。抑郁症显著放大了心理失败对自杀风险的影响，特别是在抑郁水平较高的个体中（B = 0.06, SE = 0.01, t = 6.21, p）结论：心理失败是慢性疼痛患者自杀的重要危险因素，抑郁症加剧了这种风险。在治疗中同时处理精神挫败和抑郁可能有助于降低这些患者的自杀风险。意义：本研究强化了慢性疼痛患者心理失败与自杀风险增高之间的联系。通过提供前瞻性数据，它澄清了这种关系的暂时性。考虑到慢性疼痛患者的自杀风险增加一倍，而伴随抑郁的患者很常见，这些发现具有重要的临床意义。精神上的失败和抑郁都是可以改变的。在治疗中同时解决这些问题可能有助于降低这一人群的自杀风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.