Regular Research ArticlesClinical Correlates of Suicidal Thoughts in Patients With Advanced Cancer
Section snippets
Study Sample
Patients were recruited from September 2002 to August 2008, into the Coping with Cancer (CwC) study, a multiinstitutional investigation of advanced cancer patients and their primary, informal, unpaid caregivers (National Institutes of Health grants MH63892 and CA106370: PI, Prigerson). Only data from the patient baseline interviews are included in this report. Participating sites included the Yale Cancer Center (New Haven, CT), the Veterans Affairs Connecticut Healthcare System Comprehensive
Patient Characteristics
The cohort of 700 advanced cancer patients was 72.2% white, 14.1% black, 11.5% Hispanic, 1.9% Asian, and 51.4% male (Table 1). Patients died a median of 116 days after enrollment and had the following primary cancers: gastrointestinal (24.7%), breast (9%), thoracic (25.9%), other (40.4%). Sixty-two patients (8.9%) reported thoughts of suicide. Although no gender differences emerged, being a non-Hispanic white compared with nonwhite was associated with a significantly higher prevalence of
COMMENT
This report demonstrates that there are multiple, significant clinical markers that geriatric psychiatrists and palliative care clinicians can use to identify advanced cancer patients with suicidal thoughts. The Coping with Cancer study is among the largest psychiatric epidemiologic studies of advanced cancer patients and, specifically assesses suicidality. It therefore provides useful data for elucidating the risk factors that clinicians can use to triage their patients to more rigorous
References (51)
- et al.
Prostate cancer: a significant risk factor for late-life suicide
Am J Geriatr Psychiatry
(2005) - et al.
Why do some cancer patients with depression desire an early death and others do not?
Psychomatics
(2001) - et al.
Depression, hopelessness, and suicidal ideation in the terminally ill
Psychosomatics
(1998) - et al.
A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
J Chron Dis
(1987) - et al.
Screening for suicidality in cancer patients using item 9 of the nine-item patient health questionnaire: does the item score predict who requires further assessment
Gen Hosp Pyschiatry
(2010) World Health Organization. Geneva, Switzerland
- et al.
If suicide is a public health problem, what are we doing to prevent it?
Am J Public Health
(2004) - et al.
Suicide risk in cancer patients from 1960 to 1999
J Clin Oncol
(2004) - et al.
Incidence of suicide in persons with cancer
J Clinicol Oncol
(2008) - et al.
Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer
JAMA
(2000)
The internal struggle between the wish to die and the wish to live: a risk factor for suicide
Am J Psychiatry
Desire for death in the terminally ill
Am J Psychiatry
The schedule of attitudes toward hastened death: measuring desire for death in terminally ill cancer patients
Cancer
Factors associated with the wish to hasten death: a study of patients with terminal illness
Psychol Med
High suicide rate among cancer patients fuels prevention discussions
JNCI
Cancer, mental disorders, suicidal ideation and attempts in a large community sample
Psychooncology
Suicidality in terminally ill Japanese patients with cancer
Cancer
Correlates of suicide ideation in a population-based sample of cancer patients
J Psychosoc Oncol
Predictive factors for suicidal ideation in patients with unresectable lung carcinoma
Cancer
Suicidal and deliberate self-harm ideation among patients with physical illness: the role of coping styles
Suicide Life Threat Behav
Problem-solving in suicide attempters
Psychol Med
Better off dead: suicidal thoughts in cancer patients
J Clin Oncol
Suicide risk in cancer patients from 1960 to 1999
J Clinicol Oncol
Suicide in cancer patients in south east england from 1996 to 2005: a population-based study
Br J Cancer
Suicides among Danish cancer patients 1971–1999
Br J Cancer
Cited by (0)
The authors indicated no potential conflicts of interest or financial disclosures. All authors have read and approved the manuscript.
This study was approved by the human subjects committee prior to the research being conducted at each institution and all participants provided written informed consent.
Dr. Prigerson, the principal investigator for this study, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
This research was supported in part by the following grants to Dr. Prigerson: MH63892 from the National Institute of Mental Health and CA106370 and CA156732 from the National Cancer Institute; a pilot grant from the American Foundation for Suicide Prevention; and the Center for Psycho-Oncology and Palliative Care Research, Dana-Farber Cancer Institute.