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Am J Prev Med. 2017 Sep;53(3):308-315. doi: 10.1016/j.amepre.2017.04.001. Epub 2017 Jun 12.

Major Physical Health Conditions and Risk of Suicide.

Author information

1
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan; Behavioral Health Services, Henry Ford Health System, Detroit, Michigan. Electronic address: bahmeda1@hfhs.org.
2
Public Health Sciences, Henry Ford Health System, Detroit, Michigan.
3
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan; Public Health Sciences, Henry Ford Health System, Detroit, Michigan.
4
HealthPartners Institute, Bloomington, Minnesota.
5
Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
6
Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
7
Center for Health Research, Kaiser Permanente Hawaii, Honolulu, Hawaii.
8
School of Public Health, Georgia State University, Atlanta, Georgia; Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, Georgia.
9
Department of Family Medicine, University of Colorado at Denver, Denver, Colorado.
10
Behavioral Health Services, Henry Ford Health System, Detroit, Michigan.
11
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan; Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan.
12
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan.
13
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.
14
Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, Georgia.
15
Kaiser Permanente Washington, Seattle, Washington.

Abstract

INTRODUCTION:

Most individuals make healthcare visits before suicide, but many do not have a diagnosed mental health condition. This study seeks to investigate suicide risk among patients with a range of physical health conditions in a U.S. general population sample and whether risk persists after adjustment for mental health and substance use diagnoses.

METHODS:

This study included 2,674 individuals who died by suicide between 2000 and 2013 along with 267,400 controls matched on year and location in a case-control study conducted in 2016 across eight Mental Health Research Network healthcare systems. A total of 19 physical health conditions were identified using diagnostic codes within the healthcare systems' Virtual Data Warehouse, including electronic health record and insurance claims data, during the year before index date.

RESULTS:

Seventeen physical health conditions were associated with increased suicide risk after adjustment for age and sex (p<0.001); nine associations persisted after additional adjustment for mental health and substance use diagnoses. Three conditions had a more than twofold increased suicide risk: traumatic brain injury (AOR=8.80, p<0.001); sleep disorders; and HIV/AIDS. Multimorbidity was present in 38% of cases versus 15.5% of controls, and represented nearly a twofold increased risk for suicide.

CONCLUSIONS:

Although several individual conditions, for example, traumatic brain injury, were associated with high risk of suicide, nearly all physical health conditions increased suicide risk, even after adjustment for potential confounders. In addition, having multiple physical health conditions increased suicide risk substantially. These data support suicide prevention based on the overall burden of physical health.

PMID:
28619532
PMCID:
PMC5598765
DOI:
10.1016/j.amepre.2017.04.001
[Indexed for MEDLINE]
Free PMC Article

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