Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 9 » Issue 1

Prevalence and correlates of suicide ideation in patients with COPD: a mixed methods study

Authors Fleehart S, Fan VS, Nguyen HQ, Lee J, Kohen R, Herting JR, Matute-Bello G, Adams SG, Pagalilauan G, Borson S

Received 4 April 2014

Accepted for publication 4 July 2014

Published 4 December 2014 Volume 2014:9(1) Pages 1321—1329

DOI https://doi.org/10.2147/COPD.S65507

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Sara Fleehart,1,* Vincent S Fan,2,3,* Huong Q Nguyen,4 Jungeun Lee,1 Ruth Kohen,3 Jerald R Herting,5 Gustavo Matute-Bello,2,3 Sandra G Adams,6,7 Genevieve Pagalilauan,3 Soo Borson3

1School of Nursing, University of Washington, Seattle, WA, USA; 2VAPuget Sound Health Care Center, Seattle, WA, USA; 3School of Medicine, University of Washington, Seattle, WA, USA; 4Reseach and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; 5Department of Sociology, University of Washington, Seattle, WA, USA; 6School of Medicine, University of Texas Health Science Center; 7South Texas Veterans Health Care System, San Antonio, TX, USA

*These authors contributed equally to this paper

Purpose: The purpose of this study was to examine the prevalence and correlates of suicidal ideation (SI) in patients with stable moderate to very severe chronic obstructive pulmonary disease (COPD).
Patients and methods: We conducted an exploratory mixed methods analysis of data from participants in a longitudinal observational study of depression in COPD. We measured depression with the Patient Health Questionnaire-9 (PHQ-9), which includes an item on SI. We compared participants with and without SI in relation to sociodemographics, symptoms, anxiety, and healthcare resource use with independent t-tests and chi-square tests. Content analysis was performed on qualitative data gathered during a structured SI safety assessment.
Results: Of 202 participants, 121 (60%) had depressive symptoms (PHQ ≥6); 51 (25%) had a PHQ-9 ≥10, indicating a high likelihood of current major depression; and 22 (11%) reported SI. Compared to the 99 depressed participants without SI, those with SI were more likely to be female (59% vs 27%, P=0.004); had worse dyspnea (P=0.009), depression (P<0.001), and anxiety (P=0.003); and were also more likely to have received treatment for depression and/or anxiety (82% vs 40%, P<0.001) and more hospitalizations for COPD exacerbations (P=0.03) but had similar levels of airflow obstruction and functioning than participants without SI. Themes from the qualitative analysis among those with SI included current or prior adverse life situations, untreated or partially treated complex depression, loss of a key relationship, experience of illness and disability, and poor communication with providers.
Conclusion: Our findings suggest that current SI is common in COPD, may occur disproportionately in women, can persist despite mental health treatment, and has complex relationships with both health and life events. Adequate management of SI in COPD may therefore require tailored, comprehensive treatment approaches that integrate medical and mental health objectives.

Keywords: depression, qualitative, PHQ-9, suicide, pulmonary disease, chronic obstructive

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Readers of this article also read:

Phytofabrication of bioinduced silver nanoparticles for biomedical applications

Ahmad N, Bhatnagar S, Ali SS, Dutta R

International Journal of Nanomedicine 2015, 10:7019-7030

Published Date: 12 November 2015

Glutathione-degradable drug-loaded nanogel effectively and securely suppresses hepatoma in mouse model

Liu XG, Wang JM, Xu WG, Ding JX, Shi B, Huang KX, Zhuang XL, Chen XS

International Journal of Nanomedicine 2015, 10:6587-6602

Published Date: 22 October 2015

Significant improvement of biocompatibility of polypropylene mesh for incisional hernia repair by using poly-ε-caprolactone nanofibers functionalized with thrombocyte-rich solution

Plencner M, Prosecká E, Rampichová M, East B, Buzgo M, Vysloužilová L, Hoch J, Amler E

International Journal of Nanomedicine 2015, 10:2635-2646

Published Date: 1 April 2015

Caregivers’ burden in patients with COPD

Miravitlles M, Peña-Longobardo LM, Oliva-Moreno J, Hidalgo-Vega Á

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:347-356

Published Date: 12 February 2015