Arthritis and suicide attempts: findings from a large nationally representative Canadian survey

Abstract

The objectives of this study were (1) to determine the odds of suicide attempts among those with arthritis compared with those without and to see what factors attenuate this association and (2) to identify which factors are associated with suicide attempts among adults with arthritis. Secondary data analysis of the nationally representative 2012 Canadian Community Health Survey-Mental Health (CCHS-MH) was performed. For objective 1, those with and without arthritis were included (n = 21,744). For objective 2, only individuals who had arthritis (n = 4885) were included. A series of binary logistic regression analyses of suicide attempts were conducted for each objective, with adjustments for socio-demographics, childhood adversities, lifetime mental health and chronic pain. After full adjustment for the above listed variables, the odds of suicide attempts among adults with arthritis were 1.46. Among those with arthritis, early adversities alone explained 24 % of the variability in suicide attempts. After full adjustment, the odds of suicide attempts among those with arthritis were significantly higher among those who had experienced childhood sexual abuse (OR = 3.77), chronic parental domestic violence (OR = 3.97) or childhood physical abuse (1.82), those who had ever been addicted to drugs or alcohol (OR = 1.76) and ever had a depressive disorder (OR = 3.22) or an anxiety disorder (OR = 2.34) and those who were currently in chronic pain (OR = 1.50). Younger adults with arthritis were more likely to report having attempted suicide. Future prospective research is needed to uncover plausible mechanisms through which arthritis and suicide attempts are linked.

Attention‐deficit/hyperactivity disorder casts a long shadow: findings from a population‐based study of adult women with self‐reported ADHD

“…As previously described elsewhere (Fuller-Thomson, Agbeyaka, LaFond, & Bern-Klug, 2016;Fuller-Thomson, Ramzan, & Baird, 2016), the current research was conducted using the 2012 Canadian Community Health Survey -Mental Health (CCHS-MH), a large, nationally representative survey with a response rate of 69% (Statistics Canada 2013a). Most of the interviews (87%) were conducted in person, with the remainder of participants completing the survey over the phone.…”

“…Women with ADHD also have a significantly higher prevalence of depression, anxiety self-harm behaviours and suicide attempts than those without ADHD (Halmoy et al 2010;Hinshaw et al 2012;Swanson et al 2014). Lastly, research has shown that adults with ADHD are more likely to have experience several adverse childhood experiences including physical abuse (Fuller-Thomson et al 2014;Fuller-Thomson & Lewis 2015), sexual abuse (Ouyang et al 2008;Fuller-Thomson & Lewis 2015) and exposure to intimate partner conflict (Biederman et al 1995).…”

Blunted HPA axis activity prior to suicide attempt and increased inflammation in attempters

“…There is increased risk for suicidal behavior with the activation of inflammatory responses following treatment with interferon for patients with cancer, hepatitis C, and multiple sclerosis (Baron et al, 1993; Fragoso et al, 2010; Janssen et al, 1994); in autoimmune disorders (Fuller-Thomson et al, 2016; Ludvigsson et al, 2011); in infections (Brundin and Grit, 2016; Lund-Sorensen et al, 2016); and in diseases that involve exaggerated immune responses, such as allergies and asthma (Goodwin, 2012). Inflammation is also associated with impulsivity and aggression (Coccaro et al, 2014; Isung et al, 2014), which predict suicidal behavior (Melhem et al, 2007); and with sleep problems (Prather et al, 2009), which often precede suicidal behavior.…”

The risk of deliberate self-harm following a diagnosis of rheumatoid arthritis or ankylosing spondylitis: A population-based cohort study

“…Our study did not have data on depression or disease severity; however, our AS subjects were primarily male and younger compared to other cohorts. This may represent a particularly high risk group for severe depression [12].…”

“…Ankylosing spondylitis (AS) is far less prevalent (0.3%), with cardinal features of inflammatory back pain and stiffness, primarily in young men [9]. Despite their different clinical phenotypes, RA and AS are both associated with an elevated risk of mental illness, including depression, anxiety and substance abuse [2,[10][11][12][13]. An increased risk of completed suicide has also been described for these groups and may relate to struggles with arthritis symptoms, mental illness or a combination of both [11,13].…”