Institutional members access full text with Ovid®

Share this article on:

Predictors of Suicidal Ideation in Chronic Pain Patients: An Exploratory Study

Racine, Mélanie PhD*,†,‡; Choinière, Manon PhD‡,§; Nielson, Warren R. PhD*,†

The Clinical Journal of Pain: May 2014 - Volume 30 - Issue 5 - p 371–378
doi: 10.1097/AJP.0b013e31829e9d4d
Original Articles

Objectives: To explore whether chronic pain (CP) patients who report suicidal ideation (SI) present a distinctive profile with regard to their sociodemographic characteristics, physical health, psychological well-being, cognitions, and use of antidepressants, illicit drugs, and alcohol for pain relief.

Methods: Eighty-eight CP patients completed self-administered questionnaires during their intake assessment at 3 pain clinics located in the province of Québec (Canada). Patients reporting active or passive SI on the Beck Depression Inventory were compared with patients reporting no SI. Between-group univariate analyses were performed using profile variables to compare patients with and without SI. Significant variables were then entered into multiple logistic regression analyses to identify significant independent predictors of SI.

Results: Twenty-four percent of patients reported having had SI. Unemployed/disabled patients were 6 times more likely to report SI. Poor sleep quality was the only predictor of SI among the physical variables. For psychological well-being, depressive symptoms did not significantly predict SI. However, the poorer the patients perceived their mental health to be the more likely they were to report SI. Pain-related helplessness was the only predictor for SI among the cognitive variables. Patients who had used illicit drugs as a form of pain relief at any time since pain onset were 5 times more likely to report SI. Similar results were obtained for those who were on antidepressants.

Discussion: Some factors associated with SI seem pain specific, whereas others are more generally associated with SI. Better identification and understanding of these factors is essential for the development of targeted suicide prevention programs for at-risk CP patients.

*Lawson Health Research Institute

Beryl & Richard Ivey Rheumatology Day Programs, St. Joseph’s Health Care, London, ON

Centre de recherche, Centre hospitalier de l’Université de Montréal (CRCHUM)

§Department of Anaesthesiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada

Supported by a grant from the Quebec Pain Research Initiative that was funded by Valorisation Recherche, Québec. Dr Mélanie Racine was a Canadian Institutes of Health Research (CIHR) Strategic Training Fellow in Pain: Molecules to Community at the time this study was conducted. The authors declare no conflict of interest.

Reprints: Mélanie Racine, PhD, Lawson Health Research Institute and St. Joseph’s Health Care, 268 Grosvenor Street, Monsignor Roney Building, Office D3-171, London, ON, Canada N6A 4V2 (e-mail:

Received December 12, 2012

Accepted May 25, 2013

© 2014 by Lippincott Williams & Wilkins