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Risk of Suicide After Diagnosis of Severe Physical Health Conditions: A Cohort Study
14 Pages Posted: 16 Jun 2022
More...Abstract
Background: The diagnosis of a severe physical health condition can cause psychological distress and lead to severe depression. The association between severe physical health conditions and risk of suicide and how the risk of suicide changes in the months following diagnosis, are not clear.
Methods: We estimated whether diagnosis of severe physical health conditions is associated with an increase in risk of death by suicide using a dataset based on the 2011 Census linked to hospital records and death registration records covering 47,354,696 people alive on 1 Jan 2017 in England. Patients diagnosed with low-survival cancers, chronic ischaemic heart disease, chronic obstructive pulmonary disease, and degenerative neurological condition were matched to individuals using socio-demographic characteristics from the Census. We estimated the cumulative incidence of death by suicide occurring between 1 January 2017 and 31 December 2021 (registered by 31 December 2021) in patients and matched controls.
Findings: Diagnosis of severe conditions was associated with an increased risk of dying by suicide. One year after diagnosis, the rate of suicide was 22.2 (95% confidence intervals: 11.1 to 33.3) per 100,000 low-survival cancer patients compared to 9.1 (4.6 to 13.6) per 100,000 matched controls. For COPD patients, the one-year suicide rate was 23.6 (20.0 to 27.2) per 100,000 COPD patients (matched controls: 9.7, 7.6 to 11.7), for ischaemic heart disease 16.4 (14.1 to 18.8) per 100,000 patients (matched controls: 8.5, 6.9 to 10.0), for degenerative neurological conditions 107.7 (23.3 to 192.1) per 100,000 patients. The increase in risk was more pronounced in the first six months after diagnosis or first treatment.
Interpretation: Further research is needed to understand the drivers of suicide in patients diagnosed with severe conditions. Identification of treatable mental illness following diagnosis of severe physical health conditions is essential.
Funding: Office for National Statistics
Declaration of Interest: None to declare.
Ethical Approval: This study was ethically self-assessed against the ethical principles of the National Statistician's Data Ethics Advisory Committee (NSDEC) using NSDEC's ethics self-assessment tool. We engaged with the UK Statistics Authority Data Ethics team and it was decided that ethical approval was not required.
Keywords: suicide, severe illness
Suggested Citation: Suggested Citation