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Suicidal behaviors in patients with rheumatic diseases: a narrative review

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Abstract

Chronic rheumatic disorders are characterized by inflammation and chronic pain, and both anxiety and depression have been frequently observed in these patients. Depression and chronic pain are recognized as risk factors for the development of suicidal behaviors. Accordingly, the objective of the present review is to provide a comprehensive review of suicidal behaviors associated with rheumatic diseases. Medline and EMBASE were searched for English language publications using key words related with rheumatic diseases, suicide, suicide attempts, and suicidal ideation. 34 records (30 full-length published papers and 4 studies published in abstract form) that included data related to the frequency and/or potential determinants of suicidal behaviors in rheumatic diseases were included in the review. It was found that both suicidal ideation and completed suicide seem to be more frequent in patients experiencing systemic lupus erythematosus, fibromyalgia and arthritis. Major determinants were comorbid depression in fibromyalgia and arthritis, and neuropsychiatric disease in systemic lupus erythematosus. Based on these findings, suicide risk should be assessed in patients suffering from systemic lupus erythematosus, fibromyalgia and/or arthritis.

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Acknowledgements

We would like to thank Professor Maria Tektonidou for her comments and critical review of a previous draft of this manuscript.

Funding

This study did not receive any specific grant from funding agencies.

Author information

Authors and Affiliations

  1. Instituto de Neurociencias, Universidad de Granada, Avenida del Conocimiento s/n, 18100, Armilla, Spain

    Elena P. Calandre & Fernando Rico-Villademoros

  2. The Hospital for Sick Children, The Peter Gilgan Centre for Research and Learning, 686 Bay St., Toronto, ON, M5G 0A4, Canada

    Mahmoud Slim

Authors
  1. Elena P. Calandre
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  2. Fernando Rico-Villademoros
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  3. Mahmoud Slim
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Contributions

EPC: Study concept and design, revision and assessment of primary studies, article drafting and critical revision of the manuscript’s intellectual content. FRV: Searching the literature, revision and assessment of primary studies, preparation of tables, article drafting and critical revision of the manuscript’s intellectual content. MS: Searching the literature, revision and assessment of primary studies, article drafting and critical revision of the manuscript’s intellectual content.

Corresponding author

Correspondence to Mahmoud Slim.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Calandre, E.P., Rico-Villademoros, F. & Slim, M. Suicidal behaviors in patients with rheumatic diseases: a narrative review. Rheumatol Int 38, 537–548 (2018). https://doi.org/10.1007/s00296-017-3909-9

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