Pain conditions and suicide attempts in military veterans: A case-control design
Abstract
OBJECTIVE
Specific pain conditions such as back pain and migraines are associated with increased risk of suicide mortality after accounting for key covariates. The purpose of the current study was to assess the associations of specific pain conditions with suicide attempts.
DESIGN
Case-control.
SETTING
Veterans Health Administration (VHA).
SUBJECTS
Individuals who utilized VHA services with a record of a suicide attempt (n = 30,051) in Fiscal Years 2013 and 2014 were identified and propensity score matched with controls with no such record (n = 30,051).
METHODS
Data on pain condition diagnoses (back pain, arthritis, migraine, headaches, psychogenic pain, neuropathy, fibromyalgia) psychiatric diagnoses, medical comorbidity, and demographics were extracted from VHA medical record and suicide surveillance datasets.
RESULTS
Unadjusted logistic regression analyses found that each of the pain conditions were associated with suicide attempts (e.g., back pain: Odds ratio [OR]=3.25, 95% Confidence Interval [CI]=3.12-3.39). After adjusting for mental health conditions, medical comorbidity, and each of the pain conditions, the effects were attenuated across pain conditions; however, remained significant for each of the pain conditions except for fibromyalgia. Specifically, back pain (OR = 1.25, 95% CI = 1.19-1.32), migraines (OR = 1.29, 95% CI = 1.14-1.46), headaches (OR = 1.33, 95% CI = 1.19-1.48), and neuropathic pain (OR = 1.52, 95% CI = 1.33-1.74) were each associated with…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 30,051 participants or records.
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