Association between psychological pain and suicidal behaviour in a cohort of patients at high risk of suicide

Abstract

Background and Objectives

Suicide is a major global public health issue. Pain, both psychological and physical, are potential risks factors for suicidal behaviour (SB). This study aims to explore the relationship between psychological and physical pain and SB in individuals at high risk of suicide.

Methods

This prospective cohort study included 322 participants recruited from emergency departments, psychiatric inpatient units, and outpatient mental health services in two hospitals in Madrid (Spain). Participants completed assessments at baseline and six months. Psychological and physical pain were measured using validated Visual Analog Scales (VAS). The primary outcome was the occurrence of suicidal events, documented through medical records and follow-up interviews. Kaplan-Meier survival analyses estimated the occurrence of suicidal events after 6 months of follow-up. Factors associated with suicidal events were analysed using univariate and multivariate Cox regression models to identify independent predictors of SB.

Results

Severe psychological pain in the previous 15 days was significantly associated with an increased risk of SB (p = 0.017), independently of depression severity. Younger age also emerged as a significant risk factor. No association was found between physical pain and SB.

Conclusions

Psychological pain is a key predictor of SB and should be a focus in suicide risk assessments. Further research is needed to improve measurement tools and develop targeted interventions in order to treat psychological pain effectively.