High risk of depression and suicide attempt among chronic pain patients: Always explore catastrophizing and suicide thoughts when evaluating chronic pain patients

Breivik, Harald; Rème, Silje Endresen; Linton, Steven J.

doi:10.1016/j.sjpain.2013.11.004

Cited by 15 publications

(9 citation statements)

References 6 publications

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“…The pattern of previously published results related to ST in people with chronic pain suggests that factors that either enhance distress or promote avoidance, such as catastrophizing (Edwards et al., ; Breivik et al., ), perceiving oneself to be a burden on others (Kanzler et al., ; Fishbain et al., ; Wilson et al., ), feeling helpless (Racine et al., ), and having low self‐efficacy (Campbell et al., ) are positively associated with ST. The current findings are consistent with these in the sense that factors here known to counteract avoidance are negatively associated with ST. Current findings are also consistent with studies in military veteran populations, including those being treated for depression, showing that psychological inflexibility predicts ST (Debeer et al., ), and that ACT leads to decreases in ST (Walser et al., ).…”

Section: Discussionmentioning

confidence: 96%

“…Relatively little is known about psychological processes underlying ST in people with chronic pain. What is known in these people is that ST is related to pain‐related catastrophic thinking (Edwards et al., ; Breivik et al., ), perceiving oneself to be a burden on others (Kanzler et al., ; Fishbain et al., ; Wilson et al., ), feeling helpless (Racine et al., ), and to low self‐efficacy (Campbell et al., ). What is lacking, however, is an overarching theoretical approach that can (1) encompass these factors, (2) include the potentially broad range of factors that lead to ST as a means of avoidance or escape, and (3) orient researchers and clinicians towards factors that can reduce the experience and impact of ST.…”

Section: Introductionmentioning

confidence: 99%

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The role of psychological flexibility in relation to suicidal thinking in chronic pain

McCracken

Patel²,

Scott

2018

European Journal of Pain

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

The role of psychological flexibility in relation to suicidal thinking in chronic pain

McCracken

Patel²,

Scott

2018

European Journal of Pain

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“…Pain is a known risk factor for mental health problems, including suicidal ideation [12], and comorbid medical conditions have been reported as a significant risk factor for suicide [13]. Pain is also a recognized risk factor for depression, which reinforces the case for possible undiagnosed depression affecting this patient population and the need to screen medical populations for depressive symptoms [14].…”

Section: Discussionmentioning

confidence: 99%

Are pre-existing psychiatric disorders the only reason for involuntary holds in the emergency department?

et al. 2020

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Objectives:To determine the role of previous psychiatric disorders including substance use disorders on emergency department (ED) patients on involuntary holds and compare presentations, treatment, and outcomes based on cause. Methods: We conducted a retrospective study of patients ≥ 18 years old on involuntary holds in the ED of a tertiary care center from January 1, 2013, to November 30, 2015. Demographic and clinical information were collected. Those with and without prior psychiatric disorder including substance use disorder were compared. Results: We identified 251 patients of which 129 (51.4%) had a psychiatric disorder, 23 (9.2%) had a substance use disorder, and 86 (34.3%) had both. Thirteen patients (5.2%) had no psychiatric disorder or substance use disorder and the majority 10 (76.9%) were on involuntary holds due to suicidal threats related to pain or another medical problem. Patients without a psychiatric or substance use disorder were older (55 years [17.8] vs 42 [19]; P = 0.01), more likely to be married (10 [76.9%] vs 64 [26.9%]; P < 0.001), and had more medical comorbidities (10 [76.9%] vs 114 [47.9%]; P = 0.049) compared with those without a psychiatric or substance use disorder. Conclusion: Patients on involuntary holds most commonly have pre-existing psychiatric disorder including substance use disorder. Patients on involuntary holds without history of psychiatric disorder often have severe pain or other active medical conditions which may contribute to suicidal thoughts. Addressing these underlying medical issues may be crucial in preventing further psychiatric decompensation.

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“…Recent reviews reported an association between pain and suicidality, both for patients with chronic and acute pain (Fishbain, Lewis, & Gao, 2014;Tang & Crane, 2006), indicating suicidality to be an important issue in athletes with pain. Suicidal ideation in chronic pain is associated with different psychological measures, such as pain-related catastrophizing or helplessness (Breivik et al, 2014;Legarreta et al, 2018;Racine et al, 2014) and is negatively correlated with acceptance and committed action (McCracken et al, 2018), two important aspects of the concept of psychological flexibility (Hayes, Luoma, Bond, Masuda, & Lillis, 2006;McCracken & Morley, 2014). McCracken et al (2018) proposed the model of psychological flexibility as an overarching theoretical approach to comprise these different factors as precursors of suicidality in terms of avoidance of negative experiences.…”

Section: Discussionmentioning

confidence: 99%

Depression and suicidal ideation in high‐performance athletes suffering from low back pain: The role of stress and pain‐related thought suppression

Konietzny

Chehadi

Levenig

et al. 2019

European Journal of Pain

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Background Depression and suicidal ideation are important health problems in athletes suffering from pain. Dysfunctional pain cognitions, that is, pain‐related thought suppression (PTS), may play an important role in their aetiology. Thought suppression was shown to increase depressive mood, particularly in highly stressed individuals. This cross‐sectional study examines the relationship between PTS and stress on depression and suicidal ideation in athletes with pain. Methods A total of 159 athletes with non‐specific low back pain completed a set of questionnaires to measure PTS, depression and stress. Participants were split into groups with high and low stress, and high and low PTS. Two‐way ANOVA calculated main effects for PTS, stress and a PTS*stress interaction, with depressive symptoms as dependent. Subsequently, distribution tests were calculated, investigating if the presence of clinically relevant depression and suicidal ideation is dependent of conditions of high/low PTS and stress. Results A main effect of stress demonstrated higher depression scores in highly stressed athletes. Further, a significant PTS*stress interaction showed elevated depression scores in athletes with high PTS and high stress. Distribution analysis revealed positive associations between PTS, stress and depression, with depression being most frequent among athletes with high PTS and high stress. Suicidal ideation was not significantly associated with PTS and only weakly correlated with stress. Conclusions Our findings show that PTS is the most common pain response in athletes with pain. The results indicate a higher prevalence of depression and elevated depressive symptoms in athletes experiencing high stress, seemingly more pronounced when highly engaging in PTS. Significance This study contributes to the understanding of depression in athletes with pain, suggesting stress and pain‐related thought suppression to increase symptoms and prevalence of depression. As athletes often experience acute or chronic pain, understanding the impact of pain cognitions on health outcomes is an important step in the optimization of treatments.

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High risk of depression and suicide attempt among chronic pain patients: Always explore catastrophizing and suicide thoughts when evaluating chronic pain patients

Cited by 15 publications

References 6 publications

The role of psychological flexibility in relation to suicidal thinking in chronic pain

The role of psychological flexibility in relation to suicidal thinking in chronic pain

Are pre-existing psychiatric disorders the only reason for involuntary holds in the emergency department?

Depression and suicidal ideation in high‐performance athletes suffering from low back pain: The role of stress and pain‐related thought suppression

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