Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-26T03:18:25.420Z Has data issue: false hasContentIssue false
  • English
  • Français

Pain and suicide: what should we tell our trainees?

Published online by Cambridge University Press:  23 December 2021

Soroush Pakniyat-Jahromi Open the ORCID record for Soroush Pakniyat-Jahromi [Opens in a new window] ,
Panagiota Korenis  and
Leo Sher
Soroush Pakniyat-Jahromi*
Affiliation:
Department of Psychiatry, BronxCare Health System, Bronx, NY, USA Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Panagiota Korenis
Affiliation:
Department of Psychiatry, BronxCare Health System, Bronx, NY, USA Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Leo Sher
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Psychiatry, James J. Peters Veterans’ Administration Medical Center, Bronx, NY, USA
*
Author for correspondence: Soroush Pakniyat-Jahromi, Emails: sjahromi@bronxcare.org, soroushpakniyat@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Chronic pain is a debilitating medical condition affecting a significant percentage of the population worldwide. Considerable evidence suggests that pain is an independent risk factor for suicide and inadequately managing pain has been identified as a risk for suicidal behaviour. Additionally, medications used to treat pain may also contribute to suicidal behaviour. Extensive research on pain highlights deficiencies in the clinical management on pain with more gaps in care when patients have pain in combination with mental illness and suicidal behaviour. Providing trainees additional knowledge and equipping them with relevant tools to screen and manage chronic pain efficiently is a potential strategy to mitigate suicide risk. Also, trainees need to be educated on how to screen for suicidality in individuals with pain and apply suicide prevention interventions. This paper will emphasise the necessity to improve education about pain, its close relationship with suicide and effective suicide screening as well as management strategies for medical providers. With additional research, it is the hope that novel treatment modalities will be developed to treat pain to improve the quality of life of individuals suffering from this condition and to decrease suicide risk in this patient population.

Keywords

chronic painmultidisciplinary approachpain managementsuicidetrainee education
Type
Perspective
Information
Acta Neuropsychiatrica , Volume 34 , Issue 3 , June 2022 , pp. 127 - 131
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Scandinavian College of Neuropsychopharmacology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aboumrad, M, Shiner, B, Riblet, N, Mills, PD and Watts, BV (2018) Factors contributing to cancer-related suicide: a study of root-cause analysis reports. Psychooncology 27(9), 2237–2244.CrossRefGoogle ScholarPubMed
Berndt, S, Maier, C and Schutz, HW (1993) Polymedication and medication compliance in patients with chronic non-malignant pain. Pain 52(3), 331–339.CrossRefGoogle ScholarPubMed
Bohnert, A, Guy, GP and Losby, JL (2018) Opioid prescribing in the United States before and after the Centers for Disease Control and Prevention’s 2016 opioid guideline. Annals of Internal Medicine 169(6), 367–375.CrossRefGoogle ScholarPubMed
Boulanger, A, Clark, AJ, Squire, P, Cui, E and Horbay, GL (2007) Chronic pain in Canada: have we improved our management of chronic noncancer pain? Pain Research and Management 12(1), 39–47.CrossRefGoogle ScholarPubMed
Calati, R, Bakhiyi, CL, Artero, S, Ilgen, M and Courtet, P (2015) The impact of physical pain on suicidal thoughts and behaviors: metaanalyses. Journal of Psychiatric Research 71, 16–32.CrossRefGoogle Scholar
Choiniere, M, Dion, D, Peng, P, Banner, R, Barton, PM, Boulanger, A, Clark, AJ, Gordon, AS, Guerriere, DN, Guertin, MC, Intrater, HM, Lefort, SM, Lynch, ME, Moulin, DE, Ong-Lam, M, Racine, M, Rashiq, S, Shir, Y, Taenzer, P and Ware, M (2010) The Canadian STOP-PAIN project - part 1: who are the patients on the waitlists of multidisciplinary pain treatment facilities? Canadian Journal of Anesthesia 57(6), 539–548.CrossRefGoogle Scholar
Clauw, JD, Hauser, W, Cohen, SP and Fitzcharles, M (2020) Considering the potential for an increase in chronic pain after the COVID-19 pandemic. Pain 161(8), 1694–1697.CrossRefGoogle ScholarPubMed
Compton, WM and Volkow, ND (2006) Major increases in opioid analgesic abuse in the United States: concerns and strategies. Drug and Alcohol Dependence 81(2), 103–107.CrossRefGoogle ScholarPubMed
Costigan, M, Scholz, J and Woolf, CJ (2009) Neuropathic pain: a maladaptive response of the nervous system to damage. Annual Review of Neuroscience 32(1), 1–32.CrossRefGoogle Scholar
Cox-Martin, E, Anderson-Mellies, A, Borges, V and Bradley, C (2020) Chronic pain, health-related quality of life, and employment in working-age cancer survivors. Journal of Cancer Survivorship 14(2), 179–187.CrossRefGoogle ScholarPubMed
Crabtree, A, Rose, C, Chong, M and Smolina, K (2019) Effects of the new prescribing standards in British Columbia on consumption of opioids and benzodiazepines and z drugs. Canadian Family Physician 65(5), e231–e237.Google ScholarPubMed
Danilov, A, Danilov, A, Barulin, A, Kurushine, O and Latysheva, N (2020) Interdisciplinary approach to chronic pain management. Postgraduate Medicine 132(suppl 3), 5–9.CrossRefGoogle ScholarPubMed
Dayer, L, Breckling, MN, Kling, BS, Lakkad, M, McDade, ER and Painter, JT (2019) Association of the “CDC Guideline for Prescribing Opioids for Chronic Pain” with emergency department opioid prescribing. Journal of Emergency Medicine 57(5), 597–602.CrossRefGoogle ScholarPubMed
Dowell, D, Haegerich, TM and Chou, R (2016) CDC guideline for prescribing opioids for chronic pain--United States. JAMA 315(15), 1624–1645.CrossRefGoogle Scholar
Elman, I, Borsook, D and Volkow, ND (2013) Pain and suicidality: insights from reward and addiction neuroscience. Progress in Neurobiology 109(1), 1–27.CrossRefGoogle ScholarPubMed
El-Tallawy, SN, Nalamasu, R, Pergolizzi, JV and Gharibo, C (2020) Pain management during the COVID-19 pandemic. Pain and Therapy 9(2), 453–466.CrossRefGoogle ScholarPubMed
Eriksen, J, Jensen, MK, Sjogren, P, Ekholm, O and Rasmussen, NK (2003) Epidemiology of chronic non-malignant pain in Denmark. Pain 106(3), 221–228.CrossRefGoogle ScholarPubMed
Fayaz, A, Croft, P, Langford, RM, Donaldson, LJ and Jones, GT (2016) Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Journals 6(6), e010364.Google ScholarPubMed
Fields, H and Basbaum, A (1999) Textbook of Pain. London, GB: Churchill Livingstone.Google Scholar
Gaskin, DJ and Richard, P (2012) The economic costs of pain in the United States. The Journal of Pain 13(8), 715–724.CrossRefGoogle ScholarPubMed
Gatchel, RJ, McGeary, DD, McGeary, CA and Lippe, B (2014) Interdisciplinary chronic pain management: past, present, and future. American Psychologist 69(2), 119–130.CrossRefGoogle ScholarPubMed
Gitlin, DA, Levenson, JL and Lyketsos, CG (2004) Psychosomatic medicine: a new psychiatric subspecialty. Academic Psychiatry 28(1), 4–11.CrossRefGoogle ScholarPubMed
Glare, P, Aubrey, KR and Myles, PS (2019) Transition from acute to chronic pain after surgery. The Lancet 393(10180), 1537–1546.CrossRefGoogle ScholarPubMed
Guerriere, DN, Choiniere, M, Dion, D, Peng, P, Stafford-Coyte, E, Zagorski, B, Banner, R, Barton, PM, Boulanger, A, Clark, AJ, Gordon, AS, Guertin, MC, Intrater, HM, Lefort, SM, Lynch, ME, Moulin, DE, Ong-Lam, M, Racine, M, Rashiq, S, Shir, Y, Taenzer, P and Ware, M (2010) The Canadian STOP-PAIN project - part 2: what is the cost of pain for patients on waitlists of multidisciplinary pain treatment facilities? Canadian Journal of Anesthesia 57(6), 549–558.CrossRefGoogle ScholarPubMed
Ho, TP and Tay, MS (2004) Suicides in general hospitals in Hong Kong: retrospective study. Hong Kong Medical Journal 10, 319–324.Google Scholar
Hung, CI, Liu, CY, Liao, MN, Chang, YH, Yang, YY and Yeh, EK (2000) Self-destructive acts occurring during medical general hospitalization. General Hospital Psychiatry 22(2), 115–121.CrossRefGoogle ScholarPubMed
Kallurkar, A, Kulkarni, Sh, Delfino, K, Ferraro, D and Rao, K (2019) Characteristics of chronic pain among head and neck cancer patients treated with radiation therapy: a retrospective study. Pain Research and Management 2019(2), 1–8.CrossRefGoogle ScholarPubMed
Kehlet, H (1997) Multimodal approach to control postoperative pathophysiology and rehabilitation. British Journal of Anaesthesia 78(5), 606–617.CrossRefGoogle ScholarPubMed
Ku, BS, Li, J, Lally, C, Compton, MT and Druss, BG (2021) Associations between mental health shortage areas and county-level suicide rates among adults aged 25 and older in the USA, 2010 to 2018. General Hospital Psychiatry 70(10), 44–50.CrossRefGoogle Scholar
Lieberman, JA (1996) Compliance issues in primary care. Journal of Clinical Psychiatry 57(Suppl 7), 76–82.Google ScholarPubMed
Jeffery, MM, Hooten, WM, Jena, AB, Ross, JS, Shah, ND and Karaca-Mandic, P (2019) Rates of physician coprescribing of opioids and benzodiazepines after the release of the Centers for Disease Control and Prevention guidelines in 2016. JAMA Network Open 2(8), e198325.CrossRefGoogle ScholarPubMed
Morton, D, Jones, A and Sandhu, J (2016) Brain imaging of pain: state of the art. Journal of Pain Research 9, 613–624.CrossRefGoogle ScholarPubMed
Moulin, DE, Clark, AJ, Speechley, M and Morley-Forster, PK (2002) Chronic pain in Canada-prevalence, treatment, impact and the role of opioid analgesia. Pain Research and Management 7(4), 179–184.CrossRefGoogle ScholarPubMed
Noufi, P, Ayoub, E, Naccache, N and Richa, S (2016) Patterns of prescription of opioid analgesics in Hôtel-Dieu de France of Beyrouth. Encephale-revue De Psychiatrie Clinique Biologique Et Therapeutique 42(6), 511–516.Google Scholar
Petrosky, E, Harpaz, R, Fowler, KA, Bohm, MK, Helmick, CG, Yuan, K and Betz, CJ (2018) Chronic pain among suicide decedents, 2003 to 2014: findings from the national violent death reporting system. Annals of Internal Medicine 169(7), 448–455.CrossRefGoogle ScholarPubMed
Phillips, CJ (2009) The cost and burden of chronic pain. Reviews in Pain 3(1), 2–5.CrossRefGoogle ScholarPubMed
Piraccini, E, Byrne, H and Taddei, S (2020) Chronic pain management in COVID-19 era. Journal of Clinical Anesthesia 65, 109852.CrossRefGoogle ScholarPubMed
Qin, X, Phillips, MR, Wang, W, Li, Y, Jin, Q, Ai, L, Wei, S, Dong, G and Liu, L (2010) Prevalence and rates of recognition of anxiety disorders in internal medicine outpatient departments of 23 general hospitals in Shenyang. China General Hospital Psychiatry 32(2), 192–200.CrossRefGoogle ScholarPubMed
Racine, M (2017) Chronic pain and suicide risk: a comprehensive review. Progress in Neuropsychopharmacology and Biological Psychiatry 87(Part B), 269–280.CrossRefGoogle ScholarPubMed
Razouki, Z, Khokhar, BA, Philpot, LM and Ebbert, J (2019) Attributes, attitudes, and practices of clinicians concerned with opioid prescribing. Pain Medicine 20(10), 1934–1941.CrossRefGoogle ScholarPubMed
Rivelli, SK and Shirey, KG (2014) Prevalence of psychiatric symptoms/syndromes in medical settings. In Summergrad, P and Kathol, RG (ed), Integrated Care in Psychiatry: Redefining the Role of Mental Health Professionals in the Medical Setting. New York: Springer, pp. 5–27.CrossRefGoogle Scholar
Salsitz, E (2016) Chronic pain, chronic opioid addiction: a complex nexus. Journal of Medical Toxicology 12(1), 54–57.CrossRefGoogle ScholarPubMed
Sher, L (2021) Post-COVID syndrome and suicide risk. QJM: An International Journal of Medicine 114(2), 95–98.CrossRefGoogle ScholarPubMed
Sher, L and New, AS (2016) Understanding the role of psychiatric principles in patient care: an important goal of the Medical Student Clerkship in psychiatry. Frontiers in Public Health 4(1), 30.CrossRefGoogle Scholar
Song, XJ, Xiong, DL, Wang, ZY, Yang, D, Zhou, L and Li, RC (2020) Pain management during the COVID-19 pandemic in China: lessons learned. Pain Medicine 21(7), 1319–1323.CrossRefGoogle ScholarPubMed
Tseng, MC, Cheng, IC and Hu, FC (2011) Standardized mortality ratio of inpatient suicide in a general hospital. Journal of Formosan Medical Association 110(4), 267–269.CrossRefGoogle ScholarPubMed
Turk, DC and Rudy, TE (1991) Neglected topics in the treatment of chronic pain patients relapse, noncompliance, and adherence enhancement. Pain 44(1), 5–28.CrossRefGoogle ScholarPubMed
Von Hehn, CA, Baron, R and Woolf, CJ (2012) Deconstructing the neuropathic pain phenotype to reveal neural mechanisms. Neuron 73(4), 638–652.CrossRefGoogle ScholarPubMed
Webster, L (2017) Risk factors for opioid-use disorder and overdose. Anesthesia & Analgesia 125(5), 1741–1748.CrossRefGoogle ScholarPubMed
Wright, MT (2009) Training psychiatrists in nonpsychiatric medicine: what do our patients and our profession need? Academic Psychiatry 33(3), 181–186.CrossRefGoogle ScholarPubMed
Yanni, L, McKinney-Ketchum, J, Harrington, S, Huynh, C, Amin, S, Matsuyama, R, Coyne, P, Johnson, BA, Fagan, M, Garufi, CL (2010) Preparation, confidence, and attitudes about chronic noncancer pain in graduate medical education. Journal of Graduate Medical Education 2(2), 260–268.CrossRefGoogle ScholarPubMed