Mental illness is associated with increased risk of suicidal ideation among cancer surgical patients

Am J Surg. 2021 Jul;222(1):126-132. doi: 10.1016/j.amjsurg.2020.10.028. Epub 2020 Oct 20.

Abstract

Background: Mental illness and depression can be associated with increased risk of suicidal ideation (SI). We sought to determine the association between mental illness and SI among cancer surgical patients.

Methods: Medicare beneficiaries who underwent resection of lung, esophageal, pancreatic, colon, or rectal cancer were analyzed. Patients were categorized as no mental illness, anxiety and/or depression disorders or bipolar/schizophrenic disorders.

Results: Among 211,092 Medicare beneficiaries who underwent surgery for cancer, the rate of suicidal ideation was 270/100,000 patients. Antecedent mental health diagnosis resulted in a marked increased SI. On multivariable analysis, patients with anxiety alone (OR 1.49, 95%CI 1.04-2.14), depression alone (OR 2.60, 95%CI 1.92-3.38), anxiety + depression (OR 4.50, 95%CI 3.48-5.86), and bipolar/schizophrenia (OR 7.30, 95%CI 5.27-10.30) had increased odds of SI.

Conclusions: Roughly 1 in 370 Medicare beneficiaries with cancer who underwent a wide range of surgical procedures had SI. An antecedent mental health diagnosis was a strong risk factor for SI.

Keywords: Cancer; Mental illness; Suicidal ideation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / complications
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • Bipolar Disorder / complications
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / epidemiology*
  • Bipolar Disorder / psychology
  • Cohort Studies
  • Depressive Disorder / complications
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Male
  • Medicare / statistics & numerical data
  • Neoplasms / psychology
  • Neoplasms / surgery*
  • Postoperative Period
  • Risk Factors
  • Schizophrenia / complications
  • Schizophrenia / diagnosis
  • Schizophrenia / epidemiology*
  • Schizophrenic Psychology
  • Severity of Illness Index
  • Suicidal Ideation*
  • Surveys and Questionnaires
  • United States / epidemiology