Study finds high prevalence of suicide attempts among arthritis patients

One in every 26 men with arthritis have attempted suicide compared to one in 50 men without arthritis. Women with arthritis also had a higher prevalence of lifetime suicide attempts than women without arthritis (5.3% vs 3.2%), according to a recent study from the University of Toronto.

The study found that those with arthritis still had 46% higher odds of suicide attempts than those without arthritis even when adjustments were made for important factors such as age, income, chronic pain, and a history of mental health disorders.

"When we focused on adults with arthritis, we found that those who had experienced chronic parental domestic violence or sexual abuse during their childhood, had more than three times the odds of suicide attempts compared to adults with arthritis who had not experienced these childhood adversities. The magnitude of these associations with suicide attempts was comparable to that associated with depression, the most well-known risk factor for suicide attempts," said lead author Esme Fuller-Thomson, Sandra Rotman Endowed Chair at University of Toronto's Factor-Inwentash Faculty of Social Work & Institute for Life Course & Aging.

"Other factors associated with suicide attempts among those with arthritis include a history of drug or alcohol dependence and/or anxiety disorders," reported co-author Natasha Ramzan, a recent MSW graduate of the University of Toronto. "In addition, those with arthritis who were younger, poorer and less educated also had higher odds of suicide attempts."

The paper was published online this week in the journal Rheumatology International. Investigators examined factors associated with ever having attempted suicide in a nationally representative sample of 4,885 Canadians with arthritis and 16,859 adults without arthritis. The data was drawn from the 2012 Canadian Community Health Survey-Mental Health.

Co-author and doctoral student, Stephanie Baird, cautions that "due to the cross-sectional nature of this survey we cannot establish causality. We do not know when the arthritis began nor when the suicide attempts occurred. It is possible that other factors that were not available in the survey may confound the relationship. For example, childhood poverty, has been strongly linked to both the development of arthritis and suicide risk."

Researcher's note that the findings need to be confirmed by others using prospective data before any public health recommendations can be made. However, if confirmed, they may have significant clinical implications for professionals working with those with arthritis, particularly with patients who have experienced childhood adversities, and a history of mental illness and substance abuse.