Psychological and somatic determinants of suicidal behaviour and ideation in chronic pain patients: a systematic review

Abstract

Objectives: Individuals with chronic noncancer-related pain (CNCP) are at increased risk for suicide, making it essential to identify factors associated with suicide-related outcomes (suicidal ideation, suicide attempt, and suicide death) in this population. This study aims to explore the psychopathological and psychosocial factors related to suicide-related outcomes in individuals with CNCP. Method: A systematic review was conducted by searching databases including PubMed, PsycInfo, Embase, and Cochrane using predefined keywords and a systematic search strategy to identify psychopathological and psychosocial factors associated with suicide-related outcomes in adults with chronic CNCP. Results: A total of 49 studies identified 17 factors associated with suicide-related outcomes in CNCP: 11 psychopathological, including schizophrenia spectrum and other psychotic disorders, bipolar and related disorders, depressive disorders, anxiety disorders, obsessive-compulsive and related disorders, trauma and stressor-related disorders, personality disorders, unspecified psychopathology, substance-related and addictive disorders, somatic symptom and related disorders, and sleep-wake disorders; and 6 psychosocial, including health-related quality of life, impact of pain/pain-related beliefs, coping strategies, interpersonal relationships, psychological and emotional state, and life events. Discussion: This systematic review highlights the variety of psychopathological and psychosocial factors associated with suicide-related outcomes in CNCP, underscoring the necessity of integrating these aspects to improve pain management and patient care.