de Heer et al studied the impact of pain on suicidal ideation. A patient in pain may benefit from interventions to reduce suicidal ideation. The authors are from GGz Breburg, Tiburg University, Netherlands Institute of Mental Health and Addiction, University of Manchester, and GGz inGeest in The Netherlands.

Patient selection: pain


Outcome: suicidal ideation


Predictors of suicidal ideation:

(1) moderate to very severe pain (odds ratio 3.4)

(2) moderate to very much interference with normal activities (disability; odds ratio 2.4)


A patient with one or both of these findings should be targeted for screening and support.


Additional factors that may contribute:

(1) pre-existing mental health issues

(2) history of suicidal ideation or attempts

(3) ability of medications to control pain

(4) high doses of opioids (may be a marker for severe pain)

(5) limited coping skills

(6) isolation and lack of social support

(7) other problems (economic, etc)

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