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Suicidal/self-harm behaviors among cancer patients: a population-based competing risk analysis

Published online by Cambridge University Press:  23 November 2020

Vera Yu Men Open the ORCID record for Vera Yu Men [Opens in a new window] ,
Clifton Robert Emery ,
Tai-Chung Lam  and
Paul Siu Fai Yip
Vera Yu Men
Affiliation:
Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
Clifton Robert Emery
Affiliation:
Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
Tai-Chung Lam
Affiliation:
Department of Clinical Oncology, The University of Hong Kong, Pokfulam, Hong Kong SAR
Paul Siu Fai Yip*
Affiliation:
Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong SAR
*
Author for correspondence: Paul Siu Fai Yip, E-mail: sfpyip@hku.hk
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Abstract

Background

Cancer patients had elevated risk of suicidality. However, few researches studied the risk/protective factors of suicidal/self-harm behaviors considering the competing risk of death. The objective of this study is to systematically investigate the risk of suicidal/self-harm behaviors among Hong Kong cancer patients as well as the contributing factors.

Methods

Patients aged 10 or above who received their first cancer-related hospital admission (2002–2009) were identified and their inpatient medical records were retrieved. They were followed for 365 days for suicidal/self-harm behaviors or death. Cancer-related information and prior 2-year physical and psychiatric comorbidities were also identified. Competing risk models were performed to explore the cumulative incidence of suicidal/self-harm behavior within 1 year as well as its contributing factors. The analyses were also stratified by age and gender.

Results

In total, 152 061 cancer patients were included in the analyses. The cumulative incidence of suicidal/self-harm behaviors within 1 year was 717.48/100 000 person-years. Overall, cancer severity, a history of suicidal/self-harm behaviors, diabetes and hypertension were related to the risk of suicidal/self-harm behaviors. There was a U-shaped association between age and suicidal/self-harm behaviors with a turning point at 58. Previous psychiatric comorbidities were not related to the risk of suicidal/self-harm behaviors. The stratified analyses confirmed that the impact of contributing factors varied by age and gender.

Conclusions

Cancer patients were at risk of suicidal/self-harm behaviors, and the impacts of related factors varied by patients' characteristics. Effective suicide prevention for cancer patients should consider the influence of disease progress and the differences in age and gender.

Keywords

palliative carepsycho-oncologysuicide prevention
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 12 , September 2022 , pp. 2342 - 2351
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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