Psychology Research and Behavior Management (Mar 2023)
Demoralization and Suicidal Ideation in Chronic Pain Patients
Abstract
Vasileios Chytas,1,* Alessandra Costanza,2,3,* Viridiana Mazzola,1 Christophe Luthy,4,5 Guido Bondolfi,1,2 Christine Cedraschi5,6 1Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland; 2Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland; 3Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; 4Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva, Switzerland; 5Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland; 6Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland*These authors contributed equally to this workCorrespondence: Vasileios Chytas, Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, 1205, Switzerland, Tel +41 79 553 41 55, Fax +41 22 372 38 55, Email [email protected]: The literature has clearly stressed that patients suffering from chronic pain are at high risk of suicidal behavior (SB). Hence the need to improve the characterization of this behavior risk profile in these patients. Some findings indicate a possible relationship between demoralization and pain, with functional disability found to be correlated with demoralization. The primary objective of this study was to investigate the relationship between demoralization and suicidal ideation (SI) in patients with chronic pain. The secondary objective was to verify whether demoralization can occur independently of depression in these patients. Inclusion criteria were patients with chronic pain, with SI or not, matched for age and gender, aged > 18 years. Seventy patients with SI and 70 patients without SI were included. Between-group difference was statistically significant (F=1.064; t= 7.21, p< 0.001, d=1.22), confirming the presence of numerous and intense depressive symptoms in the patients of the SI group. Regarding the Demoralization Scale (DS), the difference between the two groups was statistically highly significant (F=1.49; t=9.44; p< 0.001, d=1.6). There was also a strong positive correlation between DS and Beck Depression Inventory (BDI-II) (R=0.749; p< 0.001 for the study group and R=0.704; p< 0.001 for the control group). Furthermore, there was a strong positive correlation between the DS and the Scale for Suicide Ideation (SSI) in the SI patients group, meaning that high demoralization is associated with higher suicidal ideation as well. Our findings did not allow us to distinguish between the notions of depression and demoralization, since the two constructs show almost the same strong positive correlation with suicidal thoughts, the two also being strongly correlated with each other.Keywords: demoralization, suicidal ideation, chronic pain, depression
