Modelling symptoms to suicide risk in individuals with inflammatory bowel disease

Abstract

Given that suicidal behaviour is a pressing concern in inflammatory bowel disease populations, this study sought to model the sequence of variables that lead to its development. Participants ( n = 282) completed online self-report questionnaires regarding predictors of suicidal behaviour. A cross-sectional model of the progression from symptoms to suicide risk revealed that biomedical variables were significantly associated with psychosocial predictors of suicidal behaviour, which were significantly related to theory-driven predictors of suicidal behaviour, which were ultimately associated with suicide risk. Evidently, interventions need to target distal predictors of suicidal behaviour to mitigate harmful downstream effects.

The association between inflammatory bowel disease and mental ill health: a retrospective cohort study using data from UK primary care

“…A study of Danish and Finnish paediatric IBD patients examined cancer and mortality risks and incidentally found a fourfold increased death rate due to suicide in IBD patients compared to the general population 10,11 . Patient surveys conducted in Canada and Korea have reported more than 30% increased risk of suicide in IBD patients, similar to the findings of the present study 27‐29 . The higher incidence rates of depression and deliberate self‐harm observed in the present study in patients with IBD diagnosed over the age of 50 are consistent with a recent study from Sweden, which highlighted higher rates of suicide in individuals with late‐onset IBD and Crohn's disease 30 .…”

“…10,11 Patient surveys conducted in Canada and Korea have reported more than 30% increased risk of suicide in IBD patients, similar to the findings of the present study. [27][28][29] The higher incidence rates of depression and deliberate self-harm observed in the present study in patients with IBD diagnosed over the age of 50 are consistent with a recent study from Sweden, which highlighted higher rates of suicide in individuals with late-onset IBD and Crohn's disease. 30 Doctors caring for patients with IBD should be conscious of the increased burden of psychiatric morbidity, with early mental health diagnosis providing the potential opportunity to improve patient outcomes and reduce the risk of deliberate self-harm.…”

Childhood trauma, depression, resilience and suicide risk in individuals with inflammatory bowel disease

“…First, clinicians should consider a multidisciplinary approach that involves both medical and psychological factors. Psychological factors should be considered with assessments of depressive symptomology and/or suicide risk, particularly if patients with IBD present with medical factors that are associated with elevated suicide risk (e.g., active disease, high levels of pain; Mihajlovic et al, 2020 ). Identification and treatment of depression in IBD populations may be key in reducing the high rate of patients at risk for suicide ( Schwartz-Lifshitz et al, 2012 ).…”

“…Data for the present study were drawn from a larger study documenting a high prevalence rate of suicide risk and its biopsychosocial predictors in individuals with IBD ( Mihajlovic et al, 2020 ). Participants were recruited online through patient support groups and social media (e.g., Facebook) using recruitment scripts and advertisements.…”

“…Suicidal behaviours are prevalent among adults with depression ( Angst et al, 1999 ; Schwartz-Lifshitz et al, 2012 ), chronic disease ( Ferro et al, 2017 ; Zhang et al, 2018 ) and chronic pain ( Racine, 2018 ). Likewise, IBD lifetime rates of suicidal ideation have exceeded 30% ( Fuller-Thomson and Sulman, 2006 ), patients have historically reported greater suicide risk than the general population ( Gradus et al, 2010 ), and recent point prevalence estimates of suicide risk are over 40% ( Mihajlovic et al, 2020 ).…”