title: Suicide risk in dialysis: review of current literature.
abstract: BACKGROUND
  Studies have shown that patients with end-stage kidney disease (ESKD) are at risk of experiencing suicidal ideation and suicide attempt.
  
  
  METHODS
  The aim of the present review was to investigate whether there was a relationship between dialysis and suicide. A careful systematic review of the literature was conducted to determine the potential association between dialysis and suicide.
  
  
  METHODS
  Abstracts that did not explicitly mention suicide and dialysis were excluded. We identified as specific fields of interest in the analysis of dialysis or ESRD and suicidal behavior.
  
  
  RESULTS
  A total of 26 articles from peer-reviewed journals were considered and the most relevant articles (N = 13) were selected for this review.
  
  
  RESULTS
  It has been posited that suicidal ideation, occurring in dialysis, may arise from co-morbid depression and psychiatric symptoms are frequent in patients who underwent dialysis.
  
  
  CONCLUSIONS
  The present review should be considered in the light of some limitations. We did not carry out a meta-analysis because data from most of the studies did not permit it. Samples included different measurements and different outcomes, and they assessed patients at different time points.
  
  
  CONCLUSIONS
  The available data suggest that the risk of self-harm may be higher than expected in dialysis patients especially in those who suffer by depression and anxiety. Moreover, although the majority of deaths among dialysis patients is preceded by withdrawal from treatment, suicide remains a separate phenomenon.
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs-Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy. maurizio.pompili@uniroma1.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.affiliation: Sapienza University of Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Venturini
authors.affiliation: Sapienza University of Rome, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Montebovi
authors.affiliation: Sapienza University of Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Forte
authors.affiliation: Sapienza University of Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Palermo
authors.affiliation: Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Dorian A
authors.initials: DA
authors.lastname: Lamis
authors.affiliation: Sapienza University of Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Serafini
authors.affiliation: University of Genova, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Amore
authors.affiliation: Sapienza University of Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
mesh_terms: D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology*; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D013405:Suicide / Q000706:statistics & numerical data*