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Examining the Relationship Between Pain Catastrophizing and Suicide Risk in Patients with Rheumatic Disease: the Mediating Role of Depression, Perceived Social Support, and Perceived Burdensomeness

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Abstract

Purpose

Little research has examined the role of pain catastrophizing (PC) in predicting suicide among patients with rheumatic disease or the mechanisms through which it works. This study examines whether depression, perceived social support (PSS), and perceived burdensomeness (PB) mediate the relationship between PC and suicide risk. It also examines the relative importance of sociodemographic, clinical, and psychological factors in predicting suicide risk.

Methods

Three hundred sixty patients from a rheumatology clinic in Korea completed measures of pain catastrophizing, social support, depression, and perceived burdensomeness.

Results

In hierarchical multiple regression analysis, the PC magnification, PB, physical disability, and PSS were significantly related to suicide risk. Results of the serial multiple mediation analysis indicated that the total indirect effect of PC magnification on suicide risk was significant while the direct effect was not. Four specific indirect effects of PC magnification were found to be statistically significant. First of all, PC magnification was associated with suicide risk through PB and through depression and PB. PC magnification was also associated with suicide risk through depression and PSS. Lastly, PC magnification was associated with suicide risk through depression, PSS, and PB.

Conclusions

The identified pathways through which PC affects suicide risk suggest the importance of depression, PSS, and PB. Evaluation and intervention targeted at physical disability and the psychological factors of PC magnification, depression, PSS, and PB may be integrated into the management of suicide risk in patients with rheumatic disease.

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Authors and Affiliations

  1. Department of Psychology, Pusan National University, Busan, South Korea

    Eun -Jung Shim & Seung-Hee Park

  2. Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine, Medical Research Center, Seoul National University, Seoul, South Korea

    Yeong Wook Song & Dong Jin Go

  3. Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea

    Yeong Wook Song & Dong Jin Go

  4. Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea

    Kwang-Min Lee & Bong-Jin Hahm

  5. Department of Psychiatry, Gyeonggi provincial Medical Center Uijeongbu Hospital, Uijeongbusi, South Korea

    Kwang-Min Lee

  6. Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Bong-Jin Hahm

  7. Integrated Cancer Care Center, Seoul National University Cancer Hospital, Seoul, South Korea

    Bong-Jin Hahm

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  1. Eun -Jung Shim
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Correspondence to Bong-Jin Hahm.

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Funding

This study was supported by a 2-Year Research Grant of Pusan National University and by the Brain Korea 21 Plus program (F16HR31D1802), National Research Foundation of Korea.

Conflicts of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Seoul National University Hospital Institutional Review Board.

Informed Consent

We obtained the informed consent from the participants. Informed consent was obtained from all individual participants included in the study.

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Shim, E.J., Song, Y.W., Park, SH. et al. Examining the Relationship Between Pain Catastrophizing and Suicide Risk in Patients with Rheumatic Disease: the Mediating Role of Depression, Perceived Social Support, and Perceived Burdensomeness. Int.J. Behav. Med. 24, 501–512 (2017). https://doi.org/10.1007/s12529-017-9648-1

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