Suicidal ideation among Chinese cancer inpatients of general hospitals: prevalence and correlates

Abstract

Cancer patients are at high risk for suicide, particularly when they are informed about the cancer diagnosis or hospitalized for cancer treatment. Therefore, oncology healthcare settings such as large general hospitals in China, may represent an ideal setting to identify and treat suicidality in cancer patients. However, the clinical epidemiology of suicidality of Chinese cancer patients remains largely unknown. This study examined the prevalence and correlates of suicidal ideation among Chinese cancer inpatients of large general hospitals. A total of 517 cancer inpatients were consecutively recruited from two tertiary general hospitals of a metropolitan city in northern China, and administered with standardized questionnaires to collect data on sociodemographics, mental health, and cancer-related clinical characteristics. Suicidal ideation and mental health were measured with a single self-report question “In the past month, did you think about ending your life?” and Hospital Anxiety and Depression Scale, respectively. The one-month prevalence of suicidal ideation was 15.3% in Chinese cancer inpatients. In multivariable Logistic regression, depression, anxiety, moderate-to-severe pain, metastatic cancer, poor performance status, surgery, and palliative care were significantly associated with suicidal ideation. Cancer inpatients of large Chinese general hospitals have high prevalence of suicidal ideation and therefore potentially at high risk for suicide. Suicide prevention efforts for cancer inpatients should include periodic evaluation of suicidality, effective pain management, psychooncological supports, and, when necessary, psychiatric treatment and crisis intervention.

The desire to hasten death in advanced cancer patients at a Mexican palliative care service

“…Patients with advanced cancer can experience physical, psychological, social, and spiritual distress as a consequence of their illness and treatments (Allende-Pérez & Verástegui-Avilés, 2013) that affect their overall quality of life (Polanski, Jankowska-Polanska, Rosinczuk, Chabowski, & Szymanska-Chabowska, 2016). This population often has multiple forms of suffering and is prone to express ideas of death and suicide (Ballard, Pao, Henderson, Lee et al, 2008;Zhong, Li, Lv, Tian, Liu, et al, 2017), requesting euthanasia or assisted suicide. These type of ideas are synthesized within the term "desire to hasten death" (DHD) (Breitbart, Rosenfeld, Pessin, Kaim, Funesti-Esch et al, 2000).…”

“…The presence of DHD is common in patients who face advanced or life-threatening illnesses such as cancer. Incidence levels are variable due to the different populations and diagnostic tools used in the studies (Kremeike, Galushko, Frerich, Romotzky, Hamacher et al, 2018;Zhong et al, 2017). In patients treated in palliative care units, 11% to 55% of the patients experience momentary DHD and 3% to 20% experience a permanent DHD (Wilson et al, 2016).…”

“…Different factors associated with the presence of DHD have been described, including: being a woman, oncological diagnosis (pancreas, liver, lung, head, and neck), presence of uncontrolled physical symptoms (such as pain, nausea, fatigue) Julião, Barbosa, Oliveira, & Nunes, 2013), decrease in functionality, impact on physical appearance (Kumar, Chaudhary, Soni, & Jha, 2017;Zhong et al, 2017), unstable interpersonal relationships, poor support networks, fear of physical and psychological suffering (Quill, Back, & Block, 2016), loss of autonomy and dignity, feeling they are a burden for others (Chochinov, 2016), and the presence of psychiatric disorders such as depression and anxiety (Julião et al, 2013;Madeira et al, 2011;Mehta & Roth, 2015;Wilson et al, 2016). The latter can also have a negative impact on therapeutic adherence, hospital admissions, quality of life, and survival (Arrieta, Angulo, Núñez-Valencia, Dorantes-Gallareta, Macedo et al, 2013).…”

Factors associated with anxiety and depression level in patients with a suicide attempt

“…Statistical analysis: All data were transferred to the statistical package for Social Science 18.0 (SPSS Inc, Chicago, Illinois, USA) portable for Windows and analyzed. The risk of suicidal tendencies was determined using the anxiety (1-18) and depression (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) scores of the individuals with suicide attempts.…”

“…It is stated that suicide, which may have many reasons such as rates of suicide. Besides, it is established that individuals with problems such as dermatological disease cancer, pre-brain tumor surgery, and post-traumatic stress disorder have a higher tendency to commit suicide [3][4][5][6][7]. The aim of this study was to make a prediction about whether the suicide attempt can be predicted in advance through determining the anxiety and depression levels and the factors affecting the patients who were admitted to the emergency department of a hospital with suicide attempt and who were treated in an inpatient toxicology intensive care unit with the Hospital Anxiety and Depression Scale (HADS) also recommended in the literature [3,4,8,9].…”