The association of physical multimorbidity with suicidal ideation and suicide attempts in England: A mediation analysis of influential factors

Lee Smith, Jae Il Shin, San Lee, Jae Won Oh, Guillermo F López Sánchez, Karel Kostev, Louis Jacob, Mark A Tully, Felipe Schuch, Daragh T McDermott, Damiano Pizzol, Nicola Veronese, Junmin Song, Pinar Soysal, Ai Koyanagi

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)
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Abstract

BACKGROUND: Suicide is one of the most important causes of deaths in the United Kingdom, and the numbers are currently increasing.

AIM: There are numerous identified determinants of suicidality, and physical multimorbidity is potentially important but is currently understudied. Thus, this study aims to investigate the association of physical multimorbidity with suicidality.

METHODS: Cross-sectional data from the Adult Psychiatric Morbidity Survey 2007, which was conducted in England between October 2006 and December 2007 by the National Center for Social Research and Leicester University were analyzed. Respondents were asked about 20 physical health conditions, and suicidal ideation and suicide attempts were assessed.

RESULTS: Out of 7,403 individuals aged 16 years or over, the prevalence of physical multimorbidity, suicidal ideation, and suicide attempts were 35.1%, 4.3%, and 0.7%, respectively. After adjustment for potential confounders, compared to no physical conditions, 1, 2, 3, and ⩾4 conditions were associated with significant 1.79 (95% CI [1.25, 2.57]), 2.39 (95% CI [1.63, 3.51]), 2.88 (95% CI [1.83, 4.55]), and 6.29 (95% CI [4.12, 9.61]) times higher odds for suicidal ideation. Mediation analysis showed that cognitive problems (mediated percentage 39.2%) and disability (37.5%) explained the largest proportion between multimorbidity and suicidal ideation. Pain (38.0%) and cognitive problems (30.7%) explained the largest proportion between multimorbidity and suicide attempts.

CONCLUSION: In this large sample of UK adults, physical multimorbidity was associated with significantly higher odds for suicidal ideation and suicide attempts. Moreover, several potential mediators were identified, and these may serve as future targets for interventions that aim to prevent suicidality among people with physical multimorbidity.

Original languageEnglish
Pages (from-to)523-531
Number of pages9
JournalInternational Journal of Social Psychiatry
Volume69
Issue number3
Early online date13 Dec 2022
DOIs
Publication statusPublished online - 13 Dec 2022

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work is supported by the European Union – Next Generation EU to Dr. Guillermo F. López Sánchez.

Publisher Copyright:
© The Author(s) 2022.

Keywords

  • multimorbidity
  • suicide
  • suicidal ideation,
  • suicide attempt
  • United Kingdom
  • Adult
  • suicidal ideation
  • adult
  • Multimorbidity

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