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Citation |
Ashrafioun L, Kane C, Bishop TM, Britton PC, Pigeon WR. J. Pain 2019; 20(7): 852-859. |
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Affiliation |
VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Avenue, Canandaigua, NY, USA 14424; Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd. Rochester, NY, USA 14620. |
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Copyright |
(Copyright © 2019, Elsevier Publishing) |
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DOI |
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PMID |
30690167 |
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Abstract |
Using Veterans Health Administration (VHA) data, we assessed the extent to which mean past-year (365 days) pain intensity scores were associated with suicide attempts in the year following initiation of pain specialty services in fiscal years 2012 to 2014 (N = 221,817). Suicide attempts in the year after initiating VHA pain specialty services (i.e., index visit) were identified using medical records and a suicide surveillance sources. Adjusted hazard models accounted for key covariates (e.g., demographics, comorbidities). Subgroup analyses were also conducted on veterans without and with a suicide attempt in the year prior to the index visit to examine risk for first attempt and re-attempts. Adjusted analyses revealed that pain intensity scores were significantly associated suicide attempts following the index visit. Specifically, veterans with severe and moderate pain had a hazards ratio (HR) of 1.41 (95% Confidence Interval [CI] = 1.21-1.63) and 1.29 (95% CI = 1.13-1.47), respectively. These results were consistent for those without a past-year attempt and for those with a past-year attempt. The results suggest that moderate to severe pain intensity in the year before initiating pain specialty services may be a useful indicator of suicide risk even when considered in the context of key factors. PERSPECTIVE: This study utilized national administrative and suicide surveillance data to assess the relationship between pain intensity and suicide attempts following an initial visit for pain specialty services among veterans. The findings highlight the potential utility of assessing pain intensity as an indicator for suicide risk. Language: en |
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Keywords |
Pain intensity; psychiatric disorders; suicide attempts; suicide risk; treatment; veterans |