People who suffer from migraine, back pain and “psychogenic” pain have a significantly higher risk of committing suicide, according to a new study conducted by researchers at the Veterans Affairs Healthcare System. Psychogenic pain is a diagnosis by a physician that the origins of pain in a patient are psychological, not physical.
Several previous studies have suggested that chronic pain patients are at higher risk of suicide, but this was the first study of its kind to examine a link between suicide and specifics types of pain.
“To our knowledge, this study is the largest and most comprehensive analysis to date of associations between non-cancer pain and suicide mortality,” said Mark Ilgren, PhD, lead author and researcher at the Veterans Affairs Serious Mental Illness Treatment Resource and Evaluation Center in Ann Arbor, MI. The study is being published in the journal JAMA Psychiatry.
Ilgren and his colleagues examined the health records of over 4,800,000 patients who were treated in the VA healthcare system in 2005. Researchers then looked for an association between those with seven diagnosed pain conditions (arthritis, back pain, migraine, neuropathy, headache, fibromyalgia and psychogenic pain) and subsequent suicides from 2006 to 2008.
Patients with psychogenic pain were found to have a 58% higher risk of committing suicide compared to patients without pain, followed by patients with migraine (34%) and back pain (13%).
Patients in the VA study who were diagnosed with fibromyalgia were found to have a 16% higher risk of suicide, but due to a small sample size the data for those patients is not considered strong. Arthritis, neuropathy and headache were found to be weakly associated with suicide.
“The vast majority of people with a pain condition do not die by suicide,” Ilgren told National Pain Report.
Researchers believe certain types of pain, such as migraine, may have a biological mechanism that raise the risk of suicide even for people with no psychiatric disorders.
There is also the frustration and stress that comes with pain treatment that doesn’t work.
“Patients with these pain conditions also may be more likely to feel hopeless and to have impairments in occupational and social functioning that could lead more directly to suicidal thoughts and behaviors. Negative expectations about one’s ability to effectively manage or treat pain could lead to suicide ideation, and these effects might be greatest for certain conditions such as psychogenic pain,” Ilgren said.
Regardless of the cause, Ilgren says all physicians should be aware that their pain patients are at higher risk of suicide.
“I think the message for treatment providers, especially for primary care and pain treatment providers is to be attuned to the patient’s mental health needs, symptoms, and suicidal thoughts and plans who have pain conditions.”
A major weakness in the VA study is that most of the patients are older men, who are at higher risk of suicide than the general population. Men are also less likely to have fibromyalgia than women.
Suicide is the 10th leading cause of death in the United States, with about 34,000 people killing themselves each year.
If you or a loved one are in emotional distress, the National Suicide Prevention Lifeline has counselors available 24 hours day, seven days a week, at 800-273-TALK (8255). You are not alone. Help and hope are available.