• Am J Prev Med · Sep 2017

    Major Physical Health Conditions and Risk of Suicide.

    • Brian K Ahmedani, Edward L Peterson, Yong Hu, Rebecca C Rossom, Frances Lynch, Christine Y Lu, Beth E Waitzfelder, Ashli A Owen-Smith, Samuel Hubley, Deepak Prabhakar, L Keoki Williams, Nicole Zeld, Elizabeth Mutter, Arne Beck, Dennis Tolsma, and Gregory E Simon.
    • Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan; Behavioral Health Services, Henry Ford Health System, Detroit, Michigan. Electronic address: bahmeda1@hfhs.org.
    • Am J Prev Med. 2017 Sep 1; 53 (3): 308315308-315.

    IntroductionMost individuals make healthcare visits before suicide, but many do not have a diagnosed mental health condition. This study seeks to investigate suicide risk among patients with a range of physical health conditions in a U.S. general population sample and whether risk persists after adjustment for mental health and substance use diagnoses.MethodsThis study included 2,674 individuals who died by suicide between 2000 and 2013 along with 267,400 controls matched on year and location in a case-control study conducted in 2016 across eight Mental Health Research Network healthcare systems. A total of 19 physical health conditions were identified using diagnostic codes within the healthcare systems' Virtual Data Warehouse, including electronic health record and insurance claims data, during the year before index date.ResultsSeventeen physical health conditions were associated with increased suicide risk after adjustment for age and sex (p<0.001); nine associations persisted after additional adjustment for mental health and substance use diagnoses. Three conditions had a more than twofold increased suicide risk: traumatic brain injury (AOR=8.80, p<0.001); sleep disorders; and HIV/AIDS. Multimorbidity was present in 38% of cases versus 15.5% of controls, and represented nearly a twofold increased risk for suicide.ConclusionsAlthough several individual conditions, for example, traumatic brain injury, were associated with high risk of suicide, nearly all physical health conditions increased suicide risk, even after adjustment for potential confounders. In addition, having multiple physical health conditions increased suicide risk substantially. These data support suicide prevention based on the overall burden of physical health.Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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