title: Exploration of the relationship between disability perception, preference for death over disability, and suicidality in patients with acute and chronic pain.
abstract: OBJECTIVE
  Passive, active, and historical suicidality are associated with preference for death over disability.
  
  
  METHODS
  Community nonpatients without pain, community patients with pain, and patients with acute and chronic pain were compared for endorsement of disability perception and preference for death over disability. Phi correlations and chi-square analyses were calculated between preference for death over disability and six suicidality items representing passive, active, and historical suicidality. Logistic regression was used to predict preference for death over disability in patients with acute and chronic pain.
  
  
  RESULTS
  For patients with acute and chronic pain, endorsement of preference for death over disability correlated significantly with all six suicidality items. The logistic regression models identified the following variables as predictors for preference for death over disability in patients with acute pain: the Behavior Health Inventory (BHI 2) family dysfunction scale, history of wanting to die, and disability perception. For patients with chronic pain, predictors were the BHI 2 Borderline scale, history of wanting to die, treated fairly by family item, frequent suicide ideation, people I trust turn on me item, and disability perception. Preference for death over disability was a statistically significant predictor in patients with chronic pain for disability perception, recent suicide ideation, having a suicidal plan, and a history of wanting to die but was not a significant predictor for any suicide items in patients with acute pain.
  
  
  CONCLUSIONS
  Preference for death over disability is associated with passive and active suicide ideation and historical suicidality in patients with chronic pain.
authors.affiliation: Department of Psychiatry, Miller School of Medicine at University of Miami, Miami, Florida 33136, USA. d.fishbain@miami.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Fishbain
authors.forename: Daniel
authors.initials: D
authors.lastname: Bruns
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Meyer
authors.forename: John E
authors.initials: JE
authors.lastname: Lewis
authors.forename: Jinrao
authors.initials: J
authors.lastname: Gao
authors.forename: John Mark
authors.initials: JM
authors.lastname: Disorbio
mesh_terms: D059787:Acute Pain / Q000453:epidemiology / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D059350:Chronic Pain / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity / Q000639:trends; D003643:Death; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D055809:Illness Behavior; D008297:Male; D008875:Middle Aged; D010465:Perception; D018570:Risk Assessment; D059020:Suicidal Ideation; D055815:Young Adult