Arthritis doubles the risk of suicide attempts, according to a new study conducted at the University of Toronto and published in the June 14, 2016 issue of Rheumatology International.

Esme Fuller-Thomson, PhD, MSW and colleagues analyzed data from the 2012 Canadian Community Health Survey-Mental Health, consisting of 4 885 individuals with arthritis and 16 589 without arthritis. The found that 1 in 26 men with arthritis has attempted suicide, compared to 1 in 50 men without arthritis. The prevalence of suicide attempts in women with arthritis was likewise higher than in those without the illness (5.3% vs 3.2%, respectively).

The study had two objectives: (1) to determine the odds of suicide attempts among those with arthritis and see what factors attenuate this association; and (2) to identify factors associated with suicide attempts in these patients. For the first objective, researchers examined data from all subjects (n=21 744), and for the second objective, they included data only from individuals with arthritis.

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Even after adjusting for factors such as socio-demographics, childhood adversities, lifetime mental health, and chronic pain, those with arthritis had 46% higher odds of a suicide attempt than those without arthritis.

Early adversity alone accounted for 24% of the variability in suicide attempts among those with arthritis, the researchers stated. The odds of a suicide attempt were significantly higher among those who had experienced childhood sexual abuse, chronic parental domestic violence, and childhood physical abuse. Also, the odds increased in those with a history of addiction to drugs or alcohol, depressive disorder, anxiety disorder, and in those who were currently experiencing chronic pain. Younger adults were more likely to report having attempted suicide than were older adults.

“Future prospective research is needed to uncover plausible mechanisms through which arthritis and suicide attempts are linked,” the researchers emphasized. For this reason, no definitive public health recommendations can be made, they said. But the findings, if confirmed, could have important clinical implications in the treatment of patients with arthritis who have experienced childhood adversities, have a history of mental illness or substance abuse, or are currently experiencing chronic pain.

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Fuller-Thomson E, Ramzan N, Baird SL. Arthritis and suicide attempts: findings from a large nationally representative Canadian survey. Rheumatol Int. 2016. doi:10.1007/s00296-016-3498-z.