title: Pain and suicidal thoughts, plans and attempts in the United States.
abstract: OBJECTIVE
  This study examined the association between pain and suicidality in the general US population.
  
  
  METHODS
  Using data from the National Comorbidity Survey-Replication, we assessed relationships between four measures of pain (back and neck, headache, other nonarthritic pain and a summary score of the count of these conditions) and 12-month suicidal thoughts, plans and attempts using chi-square tests and logistic regression models. Multivariate logistic regression models controlled for demographic characteristics, chronic health conditions, mood, anxiety and substance use disorders.
  
  
  RESULTS
  In multivariate models adjusting for concurrent psychiatric disorders and other chronic medical conditions, suicidal ideation was associated with head pain (OR 1.9, 95% CI: 1.2, 3.0) and the pain summary score (OR 1.2, 95% CI: 1.0, 1.4). Suicide attempt was also associated with head pain (OR 2.3, 95% CI: 1.2, 4.4) and pain summary score (OR 1.7, 95% CI: 1.1, 2.6). Other nonarthritic pain was associated with suicide attempts (OR4.0, 95% CI: 1.8, 9.1).
  
  
  CONCLUSIONS
  These findings highlight the importance of pain as a potentially independent risk factor for suicide, particularly among those with head pain or multiple forms of co-occurring pain. Individuals suffering from chronic pain may be particularly appropriate for suicide screening and intervention efforts.
authors.affiliation: VA Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI 48109-5763, USA. marki@umich.edu
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ilgen
authors.forename: Kara
authors.initials: K
authors.lastname: Zivin
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: McCammon
authors.forename: Marcia
authors.initials: M
authors.lastname: Valenstein
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D001416:Back Pain / Q000453:epidemiology / Q000523:psychology; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000453:epidemiology / Q000523:psychology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology; D009042:Motivation; D015999:Multivariate Analysis; D019547:Neck Pain / Q000453:epidemiology / Q000523:psychology; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology* / Q000706:statistics & numerical data; D013850:Thinking; D014481:United States; D055815:Young Adult