Predictive factors for suicidal ideation in patients with unresectable lung carcinoma.
BACKGROUND
Despite serious concern over the suicidality of cancer patients in clinical oncology practice, few studies have addressed this issue. The purpose of the current study was to investigate the prevalence and predictive factors of suicidal ideation in patients with unresectable lung carcinoma in a follow-up setting.


METHODS
Patients with newly diagnosed unresectable nonsmall cell lung carcinoma participated in this study. Their suicidal ideation was assessed 6 months after disclosure of the cancer diagnosis. Predictive factors for suicidal ideation were investigated by assessing a broad range of biomedical and psychosocial factors between the time of disclosure and start of cancer therapy (baseline) and 6 months after disclosure of the cancer diagnosis (follow-up).


RESULTS
Although strong suicidal ideation was rare in this population, 13 (15%) of the 89 subjects who completed the baseline and follow-up ratings had some degree of suicidal ideation 6 months after disclosure of the cancer diagnosis. Univariate analysis revealed that significant predictive factors for suicidal ideation were pain at baseline, declining physical function, and the development of a depressive disorder. Multivariate analysis indicated that pain at baseline (odds ratio [OR] = 3.72, 95% confidence interval [CI] = 1.12-14.69, P = 0.04) and the development of a depressive disorder (OR =27.97, 95% CI = 5.18-214.14, P = 0.0003) were the final significant predictive factors.


CONCLUSIONS
Suicidal ideation among unresectable lung carcinoma patients should not be neglected because it is not rare. Comprehensive care consisting of at least earlier pain management and appropriate psychiatric intervention is indispensable to prevent subsequent suicidal ideation.
Akechi
Tatsuo
T
Psycho-Oncology Division, National Cancer Center Research Institute East, Chiba, Japan.
Okamura
Hitoshi
H
Nishiwaki
Yutaka
Y
Uchitomi
Yosuke
Y
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000473:pathology / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000473:pathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010146:Pain / Q000209:etiology; D059408:Pain Management; D011788:Quality of Life; D012307:Risk Factors; D013406:Suicide, Attempted