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Suicidal ideation in patients with cancer: A systematic review of prevalence, risk factors, intervention and assessment

Published online by Cambridge University Press:  26 September 2019

Elissa Kolva Open the ORCID record for Elissa Kolva [Opens in a new window] ,
Lilian Hoffecker  and
Emily Cox-Martin
Elissa Kolva*
Affiliation:
Division of Medical Oncology, University of Colorado - Anschutz Medical Campus
Lilian Hoffecker
Affiliation:
Health Sciences Library, University of Colorado – Anschutz Medical Campus
Emily Cox-Martin
Affiliation:
Division of Medical Oncology, University of Colorado - Anschutz Medical Campus
*
Author for correspondence: Elissa Kolva, Ph.D, Division of Medical Oncology, University of Colorado – Anschutz Medical Campus, MS 8117; 12801 E. 17th Avenue, 8th Floor, Aurora, CO80045. E-mail: elissa.kolva@ucdenver.edu
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Abstract

Objectives

Suicidal ideation (SI) underlies risk of death by suicide. It is well established that patients with cancer are at increased risk of death by suicide. Therefore, understanding SI in patients with cancer is critically important. The goal of this systematic review was to investigate the prevalence, risk factors, intervention, and assessment of SI in patients with cancer.

Methods

This systematic review was registered with the PROSPERO database (CRD42018115405) and was guided by the PRISMA statement. We searched Medline, PsycInfo, Embase, CINAHL, the Cochrane Database of Systematic Reviews, and Cochrane Central. Two reviewers independently screened abstracts and assessed for quality assurance using a revised Newcastle-Ottawa Scale.

Results

We identified 439 studies to screen for eligibility. Eligible studies included adults with cancer diagnoses and listed SI as an outcome. Ultimately, 44 studies were included in the analyses. Prevalence of SI ranged greatly from 0.7% to 46.3%. Single items drawn from validated measures were the most frequent method of assessing SI (n = 20, 45.5%); additional methods included validated measures and psychological interviews. Commonly identified risk factors for SI included age, sex, and disease/treatment-related characteristics, as well as psychological constructs including depression, anxiety, hopelessness, existential distress, and social support.

Significance of Results

Assessment of SI in patients with cancer is the concern of researchers worldwide. Prevalence of SI varied with study population and was likely influenced by the method of assessment. Psychological distress consistently predicted SI. Increasing awareness of demographic, clinical, and psychological associations is critical for risk assessment and intervention development.

Keywords

AssessmentCancerSuicidal IdeationPrevalenceRisk factors
Type
Review Article
Information
Palliative & Supportive Care , Volume 18 , Issue 2 , April 2020 , pp. 206 - 219
Copyright
Copyright © Cambridge University Press 2019

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