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      Suicidal ideation among Chinese cancer inpatients of general hospitals: prevalence and correlates

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          Abstract

          Cancer patients are at high risk for suicide, particularly when they are informed about the cancer diagnosis or hospitalized for cancer treatment. Therefore, oncology healthcare settings such as large general hospitals in China, may represent an ideal setting to identify and treat suicidality in cancer patients. However, the clinical epidemiology of suicidality of Chinese cancer patients remains largely unknown. This study examined the prevalence and correlates of suicidal ideation among Chinese cancer inpatients of large general hospitals. A total of 517 cancer inpatients were consecutively recruited from two tertiary general hospitals of a metropolitan city in northern China, and administered with standardized questionnaires to collect data on sociodemographics, mental health, and cancer-related clinical characteristics. Suicidal ideation and mental health were measured with a single self-report question “In the past month, did you think about ending your life?” and Hospital Anxiety and Depression Scale, respectively. The one-month prevalence of suicidal ideation was 15.3% in Chinese cancer inpatients. In multivariable Logistic regression, depression, anxiety, moderate-to-severe pain, metastatic cancer, poor performance status, surgery, and palliative care were significantly associated with suicidal ideation. Cancer inpatients of large Chinese general hospitals have high prevalence of suicidal ideation and therefore potentially at high risk for suicide. Suicide prevention efforts for cancer inpatients should include periodic evaluation of suicidality, effective pain management, psychooncological supports, and, when necessary, psychiatric treatment and crisis intervention.

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          Most cited references51

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          Risk factors for suicide in psychiatric outpatients: a 20-year prospective study.

          To determine the risk factors for suicide, 6,891 psychiatric outpatients were evaluated in a prospective study. Subsequent deaths for the sample were identified through the National Death Index. Forty-nine (1%) suicides were determined from death certificates obtained from state vital statistics offices. Specific psychological variables that could be modified by clinical intervention were measured using standardized scales. Univariate survival analyses revealed that the severity of depression, hopelessness, and suicide ideation were significant risk factors for eventual suicide. A multivariate survival analysis indicated that several modifiable variables were significant and unique risk factors for suicide, including suicide ideation, major depressive disorder, bipolar disorder, and unemployment status.
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            Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey.

            General population survey data are presented on the lifetime prevalence of suicide attempts as well as transition probabilities to onset of ideation, plans among ideators, and attempts among ideators either with or without a plan. Risk factors for these transitions are also studied. Data are from part II of the National Comorbidity Survey, a nationally representative survey carried out from 1990 to 1992 in a sample of 5877 respondents aged 15 to 54 years to study prevalences and correlates of DSM-III-R disorders. Transitions are estimated using life-table analysis. Risk factors are examined using survival analysis. Of the respondents, 13.5% reported lifetime ideation, 3.9% a plan, and 4.6% an attempt. Cumulative probabilities were 34% for the transition from ideation to a plan, 72% from a plan to an attempt, and 26% from ideation to an unplanned attempt. About 90% of unplanned and 60% of planned first attempts occurred within 1 year of the onset of ideation. All significant risk factors (female, previously married, age less than 25 years, in a recent cohort, poorly educated, and having 1 or more of the DSM-III-R disorders assessed in the survey) were more strongly related to ideation than to progression from ideation to a plan or an attempt. Prevention efforts should focus on planned attempts because of the rapid onset and unpredictability of unplanned attempts. More research is needed on the determinants of unplanned attempts.
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              Violence against doctors: Why China? Why now? What next?

              The Lancet (2014)
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                Author and article information

                Journal
                Oncotarget
                Oncotarget
                Oncotarget
                ImpactJ
                Oncotarget
                Impact Journals LLC
                1949-2553
                11 April 2017
                15 February 2017
                : 8
                : 15
                : 25141-25150
                Affiliations
                1 Affiliated Wuhan Mental Health Center, The Ninth Clinical School, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, People's Republic of China
                2 First Clinical Medical College & School of Basic Medical Science, Peking University, Beijing, People's Republic of China
                3 Department of Psychiatry, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, People's Republic of China
                4 Department of Healthcare, Tianjing Medical University General Hospital, Tianjin, People's Republic of China
                5 Department of Psychiatry, Tianjin Fourth Central Hospital, Tianjin, People's Republic of China
                6 Department of Radiology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, People's Republic of China
                7 Department of Psychology, General Hospital of Beijing Military Region, Beijing, People's Republic of China
                8 Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, People's Republic of China
                Author notes
                Correspondence to: Ran Tao, bjptaoran@ 123456126.com
                Article
                15350
                10.18632/oncotarget.15350
                5421916
                28212579
                53664bcc-d185-4eb6-ad9f-e4f3970fc602
                Copyright: © 2017 Zhong et al.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 20 October 2016
                : 17 January 2017
                Categories
                Research Paper

                Oncology & Radiotherapy
                cancer,inpatient,suicidal ideation,prevalence,correlate
                Oncology & Radiotherapy
                cancer, inpatient, suicidal ideation, prevalence, correlate

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