Severe Pain Predicts Greater Likelihood of Subsequent Suicide

Authors

  • Mark A. Ilgen PhD,

    Corresponding author
    1. VA Serious Mental Illness Treatment Research and Evaluation Center in Ann Arbor, MI, and with (except KLA) the Department of Psychiatry at the University of Michigan, Ann Arbor
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  • Kara Zivin PhD,

    1. VA Serious Mental Illness Treatment Research and Evaluation Center in Ann Arbor, MI, and with (except KLA) the Department of Psychiatry at the University of Michigan, Ann Arbor
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  • Karen L. Austin MPH,

    1. VA Serious Mental Illness Treatment Research and Evaluation Center in Ann Arbor, MI, and with (except KLA) the Department of Psychiatry at the University of Michigan, Ann Arbor
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  • Amy S. B. Bohnert PhD,

    1. VA Serious Mental Illness Treatment Research and Evaluation Center in Ann Arbor, MI, and with (except KLA) the Department of Psychiatry at the University of Michigan, Ann Arbor
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  • Ewa K. Czyz MA,

    1. VA Serious Mental Illness Treatment Research and Evaluation Center in Ann Arbor, MI, and with (except KLA) the Department of Psychiatry at the University of Michigan, Ann Arbor
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  • Marcia Valenstein MD, MS,

    1. VA Serious Mental Illness Treatment Research and Evaluation Center in Ann Arbor, MI, and with (except KLA) the Department of Psychiatry at the University of Michigan, Ann Arbor
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  • Amy M. Kilbourne PhD, MPH

    1. VA Serious Mental Illness Treatment Research and Evaluation Center in Ann Arbor, MI, and with (except KLA) the Department of Psychiatry at the University of Michigan, Ann Arbor
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  • This work was supported by the Department of Veterans Affairs (VA) Health Services Research and Development Service (HSR&D) grant MRP 05–137 and the VA National Serious Mental Illness and Treatment Research Evaluation Center. The views expressed in this report are those of the authors and do not necessarily represent those of the VA. We wish to thank the VA Office of Quality and Performance for access to the Large Health Survey of Veteran Enrollees Data. We have no financial or other interests that might lead to a conflict of interest.

4250 Plymouth Rd., Ann Arbor, MI, 48109-5763; E-mail: marki@umich.edu

Abstract

Using data from the 1999 Large Health Survey of Veterans, Veterans Affairs' medical records, and the National Death Index (N = 260,254), the association between self-reported pain severity and suicide among veterans as examined, after accounting for demographic variables and psychiatric diagnoses. A Cox proportional hazards regression demonstrated that veterans with severe pain were more likely to die by suicide than patients experiencing none, mild, or moderate pain (HR: 1.33; 95% CI: 1.15, 1.54), after controlling for demographic and psychiatric characteristics. These results indicate that pain evaluations should be included in comprehensive suicide assessments and suicide prevention efforts.

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