期刊
CLINICAL JOURNAL OF PAIN
卷 30, 期 6, 页码 463-471出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/AJP.0000000000000003
关键词
suicidal ideation; chronic pain; interdisciplinary treatment; treatment outcomes
资金
- Canadian Institutes of Health Research, Ottawa, ON, Canada [MOP: 93645]
- Centre for Rehabilitation Research and Development of The Ottawa Hospital Rehabilitation Centre, Ottawa, ON, Canada
Objectives:To examine suicidal ideation (SI) in individuals with chronic pain, especially change in suicidal thinking after interdisciplinary treatment.Materials and Methods:Consecutive patients (n=250) admitted to a 4-week, group-based chronic pain management program completed measures of pain intensity, functional limitations, depressive symptoms, overall distress, pain catastrophizing, self-perceived burden, and SI at pretreatment and posttreatment.Results:Before treatment, 30 (12.0%) participants were classified as having a high level of SI, 56 (22.4%) had a low level of SI, and 164 (65.6%) reported none. After treatment, there was a significant reduction in SI and improvements in all other outcomes, but there were still some individuals with high (n=22, 8.8%) or low (n=28, 11.2%) levels at discharge. Patients with high SI at baseline differed from those with no suicidal thinking on pretreatment and posttreatment measures of depression, distress, catastrophizing, and self-perceived burden, but not on pain intensity or functional limitations. Patients high in SI endorsed greater pain catastrophizing and self-perceived burden than those low in suicidal thinking. Sustained SI after treatment was associated with higher baseline levels of suicidal thinking and self-perceived burden to others, as well as a more limited overall response to treatment.Discussion:SI was common in individuals with chronic pain, although mostly at a low level. Interdisciplinary treatment may result in reduced suicidal thinking; however, some patients continue to express thoughts of self-harm. Future studies could examine processes of change and interventions for treatment-resistant suicidal concerns.
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