Prevalence: approximately 15% over 6 months
Risk factors identified in multivariate analysis:
(1) pain at baseline, even if mild
(2) development of a depressive disorder
Additional risk factor from univariate analysis but of marginal significance in the multivariate model:
(3) declining physical function, with loss of independence and autonomy
Additional factor indicated by Fishbain:
(4) duration of pain (with risk higher if pain chronic)
Ways of mitigating the risk of suicide:
(1) careful attention to pain control
(2) antidepressants
(3) provide social support with opportunities for open communication
(4) try to instill a sense of meaning or transcendence
(5) provide other palliative care, including assistance for physical impairments
