Does physical ill-health increase the risk of suicide? A census-based follow-up study of over 1 million people

Onyeka, Ifeoma N.; Maguire, Aideen; Ross, Emma; O’Reilly, Dermot

doi:10.1017/s2045796020000529

Cited by 36 publications

(25 citation statements)

References 56 publications

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“…We were unable to demonstrate the association between suicidal behaviour and having chronic medical illness because this study did not take into account the severity and types of the chronic medical illness. Another explanation was that a previous study showed the effect that medical illness has on a person’s life in terms of disruption to daily activity rather than the number of medical conditions that predict suicide risk ( 28 ), which could explain the lack of association in our study.…”

Section: Discussionmentioning

confidence: 59%

Suicidal behaviour amid first wave of COVID-19 pandemic in Malaysia: Data from the COVID-19 mental health international (COMET-G) study

et al. 2022

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During the COVID-19 pandemic, numerous social and life changes were implemented to curb the spread of the disease. The effect of lockdown and isolation predisposes the general population to various psychological health concerns. The existing determinants of suicidal behaviour were further added with social isolation, financial stress, depression, and other pandemic-related stressors. Hence, our study aimed to investigate suicidal behaviour and the associated factors among Malaysians during the COVID-19 pandemic. It is a cross-sectional online questionnaire survey that used convenient sampling, where the survey was disseminated to the public via Google Forms through social media during the first wave of the COVID-19 pandemic in Malaysia. This study is also part of a large international COVID-19 mental health international study for the general population (COMET-G). This research revealed concerns about issues related to suicidal behaviours during the beginning of the COVID-19 pandemic. Suicidal behaviours were associated with depression, sex, marital status, educational level, employment type, residential area, number of people living together, number of children, and family dynamics. The pandemic effects from psychological, social, and economic perspectives will definitely take more time for recovery. Future prevention and protection are needed especially for the highly at-risk group on top of the general population in any future unforeseen circumstances of the pandemic.

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Section: Discussionmentioning

confidence: 59%

Suicidal behaviour amid first wave of COVID-19 pandemic in Malaysia: Data from the COVID-19 mental health international (COMET-G) study

et al. 2022

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“…Many chronic illnesses lead to reduction in daily activities; ME/CFS stipulates such a reduction as a criterion for diagnosis [4]. In a recent census-based study of people with chronic physical illnesses in Northern Ireland, the degree of functional limitation in chronic illness was the largest statistical predictor of death by suicide [25]. Those who reported that their day-to-day activities were "limited a lot" were more than three times as likely to die by suicide as those without functional limitations.…”

Section: Risk Factors For Suicidementioning

confidence: 99%

Identifying and Managing Suicidality in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

et al. 2021

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Adult patients affected by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are at an increased risk of death by suicide. Based on the scientific literature and our clinical/research experiences, we identify risk and protective factors and provide a guide to assessing and managing suicidality in an outpatient medical setting. A clinical case is used to illustrate how information from this article can be applied. Characteristics of ME/CFS that make addressing suicidality challenging include absence of any disease-modifying treatments, severe functional limitations, and symptoms which limit therapies. Decades-long misattribution of ME/CFS to physical deconditioning or psychiatric disorders have resulted in undereducated healthcare professionals, public stigma, and unsupportive social interactions. Consequently, some patients may be reluctant to engage with mental health care. Outpatient medical professionals play a vital role in mitigating these effects. By combining evidence-based interventions aimed at all suicidal patients with those adapted to individual patients’ circumstances, suffering and suicidality can be alleviated in ME/CFS. Increased access to newer virtual or asynchronous modalities of psychiatric/psychological care, especially for severely ill patients, may be a silver lining of the COVID-19 pandemic.

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“…Another Census item asked “Are your day-to-day activities limited because of a health problem or disability which has lasted, or is expected to last at least 12 months?” with responses, no; yes-limited a little; yes-limited a lot. Suicide is common in those with comorbid multiple physical health conditions and limitations of daily activities ( Almeida et al, 2016 ; Onyeka et al, 2020 ).…”

Section: Methodsmentioning

confidence: 99%

The association between self-reported mental health, medication record and suicide risk: A population wide study

Onyeka

O’Reilly

Maguire

2021

SSM - Population Health

Self Cite

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Suicide mortality and mental ill health are increasing globally. Mental ill health can be measured in multiple ways. It is unclear which measure is most associated with suicide risk. This study explored the association between self-rated mental health and medication record and death by suicide. The 2011 Northern Ireland Census records of adults aged 18-74 years (n=1,098,967) were linked to a centralised database of dispensed prescription medication and death registrations until the end of 2015. Mental health status was ascertained through both a single-item self-reported question in the Census and receipt of psychotropic medication. Logistic regression models examined the association between indicators of mental ill health and likelihood of suicide mortality. Of the 1,098,967 cohort members, 857 died by suicide during the study period. Just over half of these deaths (n=429, 50.1%) occurred in individuals with neither indicator of mental ill health. Cohort members with both self-reported mental ill health and receipt of psychotropic medication had the highest risk of suicide (OR=6.13, 95%CI: 4.94–7.61), followed by those with psychotropic medication record only (OR=4.00, 95%CI: 3.28–4.88) and self-report only (OR=2.88, 95%CI: 2.16–3.84). Individuals who report mental ill health and have a history of psychotropic medication use are at a high risk of suicide mortality. However, neither measure is particularly sensitive, as both failed to signal over half of subsequent suicides. Some individuals who report poor mental health but are not in receipt of psychotropic medication are at increased risk of suicide, indicating possible unmet treatment need. The combination of the two indicators offers more precision for identifying those most at risk for targeted interventions.

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Does physical ill-health increase the risk of suicide? A census-based follow-up study of over 1 million people

Cited by 36 publications

References 56 publications

Suicidal behaviour amid first wave of COVID-19 pandemic in Malaysia: Data from the COVID-19 mental health international (COMET-G) study

Suicidal behaviour amid first wave of COVID-19 pandemic in Malaysia: Data from the COVID-19 mental health international (COMET-G) study

Identifying and Managing Suicidality in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

The association between self-reported mental health, medication record and suicide risk: A population wide study

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