Suicidality in Chronic Noncancer Pain Patients

Gilbert, Jane; Wheeler, Greg R.; Storey, Ben B.; Mick, Gregory E.; Richardson, Gay B.; Westerfield, Gloria; Broughton, Patricia G.

doi:10.1080/00207450902973336

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…Due to the association between depression and suicidal tendencies among pain patients [ 35 – 37 ], surveillance by nonpsychiatrists [ 38 , 39 ] and increased psychological care [ 40 ] are recommended in current literature.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric Disorders in Complex Regional Pain Syndrome (CRPS): The Role of the Consultation-Liaison Psychiatrist

Brinkers

Rumpelt²,

Lux

et al. 2018

Pain Research and Management

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Background Complex regional pain syndrome (CRPS) is a multifactorial disorder with complex aetiology and pathogenesis. At the outpatient pain clinic of Magdeburg University Hospital, all patients, without exception, are subject to permanent psychiatric care delivered by a consultation-liaison psychiatrist. In CRPS, psychological stabilization and treatment of the neuropathic aspects are equally important. The aim of this single-center retrospective study was to determine mental/psychiatric defects impairing pain processing at the time of investigation and show the effects of treating mental disorders and neuropathic pain with the same psychotropic drugs. Method On admission, the consultation-liaison psychiatrist examined the mental state of every patient in a semistructured interview according to AMDP (working group for methods and documentation in psychiatry). Due to the model of the Department of Anaesthesiology, we are able to compare the group of CRPS patients with all other outpatients treated for pain. Results The medical treatment of psychiatric dysfunction leads to an analgesic effect. Only every second CRPS patient had an additional psychiatric diagnosis, and 15.6% were diagnosed with depressive mood disorders and show a higher prevalence of depressive symptoms than the general population and exceed the mean for all patients treated in our pain clinic. Conclusions In neuropathies, treatment of the neuropathic pain has a modulating effect on mental disorders. As CRPS patients are frequently affected by depressions, and owing to the connection between depression and suicidal tendencies, patients should be seen by a consultation-liaison psychiatrist, and nonpsychiatrists should pay special attention to this patient group.

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Section: Discussionmentioning

confidence: 99%

Psychiatric Disorders in Complex Regional Pain Syndrome (CRPS): The Role of the Consultation-Liaison Psychiatrist

Brinkers

Rumpelt²,

Lux

et al. 2018

Pain Research and Management

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“…It may be questioned whether patients with non–cancer‐related pain and cancer patients are comparable. It has, in contrast, also been observed that patients with non–cancer‐related chronic pain show high rates of suicide (31).…”

Section: Discussionmentioning

confidence: 99%

“…With the increased suicide rate seen among patients with FM compared with that in the general population, one may ask what the causes could be. If FM is attributable to hypersensitization (41), excessive pain and fatigue (30, 31) may, together with the reported increased interleukin‐10 concentration (42, 43) and the sympathetic hyperactivity seen in some patients (44), result in nonrestorative sleep followed by serious stress reactions, because a change in the cytokine balance toward increased antiinflammatory cytokine expression leads to poor sleep quality (45).…”

Section: Discussionmentioning

confidence: 99%

Mortality in a cohort of Danish patients with fibromyalgia: Increased frequency of suicide

Dreyer

Kendall

Danneskiold‐Samsøe

et al. 2010

Arthritis & Rheumatism

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Objective. A previous study demonstrated an association between self-reported widespread body pain and increased mortality. The aim of this study was to analyze whether fibromyalgia (FM) and FM-like symptoms are related to increased mortality.Methods. From hospital records, we identified 1,361 patients referred during the period 1984-1999 because of the suspicion of FM. The cases were reviewed by reviewers who were blinded to the outcome. The cohort was followed up for a total of 5,295 person-years at risk and was linked to the Danish Mortality Register. Using the number of years at risk and sex-, age-, and calendar-specific mortality rates from the general population, cause-specific standardized mortality ratios [SMRs] were calculated.Results. We observed no overall increased mortality among patients with FM. Among the 1,269 female patients, the SMRs (95% confidence intervals [95% CIs]) for an increased risk of death from suicide, liver cirrhosis/biliary tract disease, and cerebrovascular disease were 10.5 (95% CI 4.5-20.7), 6.4 (95% CI 2.3-13.9), and 3.1 (95% CI 1.1-6.8), respectively. The suicide risk was increased at the time of diagnosis and remained increased after 5 years. Patients meeting the American College of Rheumatology criteria for FM and patients with possible FM had the same cause-specific mortality pattern. No increased cause-specific mortality was observed in the 84 male patients.Conclusion. The causes of a markedly increased rate of suicide among female patients with FM are at present unknown but may be related to increased rates of lifetime depression, anxiety, and psychiatric disorders. Risk factors for suicide should be sought at the time of the diagnosis of FM and at followup. The results also suggest that risk factors for liver disease and cerebrovascular disease should be evaluated in patients with FM.

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“…It is widely acknowledged that the main side effects of pregabalin include dizziness, lethargy, peripheral edema, and weight gain, and suicide attempts have been reported in severe cases. 37 , 38 , 39 The adverse reactions of pregabalin are often more obvious in elderly patients, exhibiting a dose‐dependent effect. In the present study, it was found that pregabalin could relieve pain and improve sleep quality; however, adverse reactions were also observed, such as dizziness and somnolence.…”

Section: Discussionmentioning

confidence: 99%

“…Safety plays an important role in drug evaluation. It is widely acknowledged that the main side effects of pregabalin include dizziness, lethargy, peripheral edema, and weight gain, and suicide attempts have been reported in severe cases 37–39 . The adverse reactions of pregabalin are often more obvious in elderly patients, exhibiting a dose‐dependent effect.…”

Section: Discussionmentioning

confidence: 99%

Xiaoketongbi Formula vs pregabalin for painful diabetic neuropathy: A single‐center, randomized, single‐blind, double‐dummy, and parallel controlled clinical trial

Chen

Liang

et al. 2022

Journal of Diabetes

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Background We assessed the efficacy and safety of the Xiaoketongbi Formula (XF) vs. pregabalin in patients with painful diabetic neuropathy (PDN). Methods Patients with PDN (n = 68) were included in a single‐center, randomized, single‐blind, double‐dummy, parallel controlled clinical trial. The primary outcome was the change in the Brief Pain Inventory for Diabetic Peripheral Neuropathy (BPI‐DPN). Secondary outcomes evaluated included the reduction of BPI‐DPN >50%, changes in the numeric rating scale‐11 (NRS‐11) score for pain, Daily Sleep Interference Diary (DSID), Patient Global Impression of Change (PGIC), nerve conduction velocity (NCV), and adverse events. Results After 10 weeks of treatment, the BPI‐DPN score reduced from 42.44 ± 17.56 to 26.47 ± 22.22 and from 52.03 ± 14.30 to 37.85 ± 17.23 in the XF and pregabalin group ( P s < 0.001), respectively. The difference in the absolute change in BPI‐DPN score between both groups was −1.79 (95% CI: −9.09, 5.50; p = 0.625). In the XF and pregabalin groups, 44.1% (15/34) and 20.6% (7/34) of patients reported a BPI‐DPN reduction >50% ( p = 0.038), respectively. There were no significant differences between groups in NRS‐11 and DSID ( P s > 0.05). A significantly greater number of patients in the XF group felt “significantly improved” or “improved” than in the pregabalin group (35.3% (12/34) vs. 11.8% (4/34), p = 0.045). The absolute change in motor nerve conduction velocity of the right median nerve was significantly different between both groups (XF group 0.7 ± 2.3 vs. pregabalin group −2.2 ± 4.1, p = 0.004). No serious adverse events were reported in either group. Conclusions XF is equivalent to pregabalin in reducing pain symptoms and improves the quality of life in patients with PDN. In addition, XF has the potential to improve nerve function by increasing NCV.

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Suicidality in Chronic Noncancer Pain Patients

Cited by 6 publications

References 16 publications

Psychiatric Disorders in Complex Regional Pain Syndrome (CRPS): The Role of the Consultation-Liaison Psychiatrist

Psychiatric Disorders in Complex Regional Pain Syndrome (CRPS): The Role of the Consultation-Liaison Psychiatrist

Mortality in a cohort of Danish patients with fibromyalgia: Increased frequency of suicide

Xiaoketongbi Formula vs pregabalin for painful diabetic neuropathy: A single‐center, randomized, single‐blind, double‐dummy, and parallel controlled clinical trial

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