Physical pain is a consistent risk factor for suicidal thoughts and behaviors, according to the results of a recent meta-analysis published in the Journal of Psychiatric Research.

Among the risk factors of suicidal thoughts and behavior, the experience of physical pain, in particular chronic pain, has received a good deal of recent attention. However, there is an urgent need to identify important predictors of suicidal behaviors that could help focus attention on vulnerable individuals, and the relationship between pain and suicidal behaviors is far from being deeply understood.

In “The impact of physical pain on suicidal thoughts and behaviors: Meta-analyses,” Raffaella Calati from the La Colombière Hospital, University of Montpellier UM1, France, and colleagues performed an electronic database search for relevant studies in individuals with any type of physical pain — including headache, back, neck, chest, musculoskeletal, abdominal and pelvic pain, arthritis, fibromyalgia, and medically unexplained or unspecified pain — versus those without reported pain. Also examined were rates of current and lifetime suicidal thoughts and behaviors, including death wish (DW), suicide ideation (SI), suicidal plan (SP), suicidal attempt (SA) and suicide (SD). A total of 31 studies were included in the analyses. Three of these studies examined lifetime DW, 12 focused on current SI, six on current SP, nine studies focused on assessing current SA, and eight were focused on SD.

The results revealed that individuals with physical pain were more likely to report lifetime DW, and both current and lifetime SI, SP and SA. In addition, researchers found that individuals with physical pain were more likely to commit suicide than those without pain. “These results corroborate the previously described pain-suicidality association and the need to carefully assess suicidal thoughts, plans and behaviors in individuals with physical pain,” the authors stated.

“Further research is required to investigate the specific impact of: 1) chronic versus acute pain, 2) different types of physical pain (e.g., medically unexplained pain), and 3) risk factors for suicide in chronic pain patients,” the  researchers concluded in their report.