Risk and predictors of attempted and completed suicide in patients with hematological malignancies.
BACKGROUND
Hematological malignancies can cause high levels of distress, but few studies have assessed risk of suicidal behavior among these patients.


METHODS
We evaluated risk of attempted and completed suicide in a cohort of 46,309 patients diagnosed with malignant lymphoma, myeloma and leukemia in Sweden 1992 to 2009 and 107,736 cancer-free subjects, using Poisson regression.


RESULTS
In all, 146 suicide attempts and 63 completed suicides occurred during a median follow up of 3.1 years (maximum 19 years). The risk of completed suicide was 3.5-fold increased among patients with myeloma [incidence rate ratio (IRR) = 3.52, 95% confidence interval (CI) = 2.05-6.03] and 1.9-fold increased among patients with lymphoma (IRR = 1.87, 95% CI = 1.31-2.67) but not significantly increased among patients with leukemia. Risk of attempted suicide was increased among patients with myeloma (IRR = 2.13, CI = 1.39-3.26) and lymphoma (IRR = 1.34, 95% CI = 1.07-1.69). Both male and female patients were at increased risk of attempted as well as completed suicide. A pre-malignant history of mental disorders conferred 15-fold to 30-fold increased risks, but elevated risks were also observed among patients without such history.


CONCLUSIONS
Suicidal actions in patients with hematological malignancies have high suicidal intent, and that subgroups of patients should be monitored for suicidal ideation.
Unit of Biostatistics, Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Mohammad
M
Mohammadi
Tahereh
T
Moradi
Matteo
M
Bottai
Johan
J
Reutfors
Yang
Y
Cao
Karin E
KE
Smedby
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007938:Leukemia / Q000453:epidemiology* / Q000523:psychology; D008223:Lymphoma / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology* / Q000523:psychology; D016012:Poisson Distribution; D012044:Regression Analysis; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D013548:Sweden; D055815:Young Adult
cancer; leukemia; lymphoma; myeloma; oncology; suicide