This work represents the continuation of the studies presented in two e-posters during the EPA 2021 conference (De Filippi et al., 2021; Rignanese et al., 2021), which addressed the physical pain-suicidality association (k=44 studies).

The aim of this meta-analysis is to provide an update of those studies, integrating data relating to adolescents, adults, and olders.

We started with the analysis of three papers, in particular a meta-analysis (Calati et al., 2015) and two systematic reviews (Hinze et al., 2019; Santos et al., 2019). After searching on Pubmed (until September 2020), data were extracted from articles comparing the rates of current and lifetime suicidal thoughts and behaviours (death wish, suicidal ideation, suicidal planning, suicide attempt and suicide death: DW, SI, SP, SA, and SD) in adolescents, adults, and olders with any type of physical pain and in individuals who did not report this condition. Data were analysed using Comprehensive Meta-Analysis Software (CMA) version 2.

67 studies were included, of which 16 on adolescents, 29 on adults, 16 on olders, and 6 on mixed ages. Although quite high between-study heterogeneity was detected in most analyses, results suggested that individuals with physical pain are more likely to report any form of suicidal outcome if compared to those not affected by pain.

Collected data are therefore in line with previous literature on this topic, which considered physical pain an extremely predictive risk factor for suicidal thoughts and behaviours. However, further research on this topic would be extremely useful.

No significant relationships.

Suicide is the third leading cause of death in adolescents (15-19 years). Physical pain is an important risk factor for suicidal thoughts and behaviors, especially in a delicate phase as adolescence.

Several studies investigated this association and the aim of this meta-analysis was to synthesize data in literature about this topic in adolescents (11-20 years).

We started from a systematic review published by Hinze and colleagues in 2019 and we searched on PubMed (January 2019-June 2020) studies comparing rates of suicidal outcomes (Suicidal Ideation, Suicide Plan, Attempt, Self-Harm: SI, SP, SA, SH) in individuals with any type of physical pain (head, back, neck, chest, stomach, abdomen, muscle, joint, arthritis) vs. those without it. Data were analyzed with Comprehensive Meta-Analysis software (CMA, version 3).

Of the 16 included studies, eleven focused on SI (68.8%), six (37.5%) on SA, four (25%) on SH and two (12.5%) on SP. Adolescents with physical pain were more likely to report SI (p < .001), SH (p < .001), SA (p = .004) and SP (p = .006). In all analyses, the between study heterogeneity was high. The presence of publication bias has been detected in SI (k≥10).

Results are in line with previous literature on this topic. Future research should investigate the specific impact of: acute vs. chronic pain; different types and intensities of pain; planned vs. impulsive action and therefore suicidal intent; role of psychological factors (in particular sensitivity and tolerance to physical pain).

Multiple epidemiologic and clinical studies have explored the relationship between physical pain and suicidal thoughts and behaviours.

The aim of this meta-analysis was to provide an update of the data already present in literature about this specific association in adults.

Starting from a meta-analysis published by Calati and colleagues in 2015, 28 studies were included in this work. After searching on Pubmed (until March 2020), data were extracted from articles comparing the rates of current and lifetime suicidal thoughts and behaviours (death wish, suicidal ideation, suicidal planning, suicide attempt and suicide death: DW, SI, SP, SA, and SD) in adults with any type of physical pain and in individuals who did not report this condition. Data were analysed using Cochrane Collaboration Review Manager software (RevMan, version 5.4).

Although high between-study heterogeneity was detected in most analyses, results suggested that adults with physical pain are more likely to report any form of suicidal outcome, except for death by suicide, compared to individuals not affected by pain. No evidence of publication bias was reported in the main analysis (lifetime SA).

Collected data are therefore in line with previous literature on this topic, which considered physical pain an extremely relevant risk factor for suicidal thoughts and behaviours. Future studies should specifically focus on alternative types of physical pain (such as medically unexplained pain or psychogenic pain) or explore the different impact of acute versus chronic pain in terms of increased suicide risk.

Suicide in the elderly is a complex and significant public health problem. The purpose of our study was to examine the role of loneliness and social integration as potential mediators in the relationship between physical pain and suicidal ideation in the elderly.

Descriptive, bivariate correlations, and moderated mediation analyses were performed.

Personal meetings were held with participants in their homes.

A total of 198 elderly men aged 65 and over.

Self-report measures: Beck Scale for Suicidal Ideation, Physical pain subscale, Multidimensional Social Integration in Later Life Scale, and University of California, Los Angeles (UCLA) Loneliness Scale (Version 3).

Our findings showed that the association between physical pain and suicidal ideation was mediated by loneliness and social integration. Further analyses revealed that this mediation model was significant among single, but not married, men.

Physical pain and social factors are both important in understanding suicidality in late life. Elderly single men who experience physical pain may be lonelier and less socially integrated, and these factors may contribute to higher risk of suicidal ideation.