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Suicidal Ideation and Suicide Attempts in General Medical Illnesses
Benjamin Druss, MD, MPH;
Harold Pincus, MD
Arch Intern Med. 2000;160:1522-1526.
Background This study examines the association between the presence of a general medical illness and suicidality in a representative sample of US young adults.
Methods Between 1988 and 1994, 7589 individuals aged 17 to 39 years were administered the Diagnostic Interview Schedule as part of a national probability survey. The survey collected information about lifetime suicidal ideation and suicide attempts, a checklist of common general medical conditions, and data on major depression, alcohol use, and demographic characteristics.
Results Whereas 16.3% of respondents described suicidal ideation at some point in their lives, 25.2% of individuals with a general medical condition, and 35.0% of those with 2 or more medical illnesses reported lifetime suicidal ideation. Similarly, whereas 5.5% of respondents had made a suicide attempt, 8.9% of those with a general medical illness and 16.2% of those with 2 or more medical conditions had attempted suicide. In models controlling for major depression, depressive symptoms, alcohol use, and demographic characteristics, presence of a general medical condition predicted a 1.3 times increase in likelihood of suicidal ideation; more specifically, pulmonary diseases (asthma, bronchitis) were associated with a two-thirds increase in the odds of lifetime suicidal ideation. Cancer and asthma were each associated with a more than 4-fold increase in the likelihood of a suicide attempt.
Conclusions A significant association was found between medical conditions and suicidality that persisted after adjusting for depressive illness and alcohol use. The findings support the need to screen for suicidality in general medical settings, over and above use of general depression instruments.
From the Departments of Psychiatry and Public Health, Yale University School of Medicine, West Haven, Conn (Dr Druss), and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC (Dr Pincus), and Departments of Psychiatry, George Washington University and Uniformed Services University for the Health Sciences, Washington, DC (Dr Pincus). Dr Pincus is now with the Department of Psychiatry, University of Pittsburgh School of Medicine, and RAND Corporation and RAND Pittsburgh Health Program, Pittsburgh, Pa.
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