Major Physical Health Conditions and Risk of Suicide

Brian K. Ahmedani, Henry Ford Health
Edward L. Peterson, Henry Ford Health
Yong Hu, Henry Ford Health
Rebecca C. Rossom
Frances Lynch
Christine Y. Lu
Beth E. Waitzfelder
Ashli A. Owen-Smith
Samuel Hubley
Deepak Prabhakar, Henry Ford Health
Keoki L. Williams, Henry Ford Health
Nicole Zeld, Henry Ford Health
Elizabeth Mutter, Henry Ford Health
Arne Beck
Dennis Tolsma
Gregory E. Simon

Abstract

INTRODUCTION: Most individuals make healthcare visits before suicide, but many do not have a diagnosed mental health condition. This study seeks to investigate suicide risk among patients with a range of physical health conditions in a U.S. general population sample and whether risk persists after adjustment for mental health and substance use diagnoses.

METHODS: This study included 2,674 individuals who died by suicide between 2000 and 2013 along with 267,400 controls matched on year and location in a case-control study conducted in 2016 across eight Mental Health Research Network healthcare systems. A total of 19 physical health conditions were identified using diagnostic codes within the healthcare systems' Virtual Data Warehouse, including electronic health record and insurance claims data, during the year before index date.

RESULTS: Seventeen physical health conditions were associated with increased suicide risk after adjustment for age and sex (p

CONCLUSIONS: Although several individual conditions, for example, traumatic brain injury, were associated with high risk of suicide, nearly all physical health conditions increased suicide risk, even after adjustment for potential confounders. In addition, having multiple physical health conditions increased suicide risk substantially. These data support suicide prevention based on the overall burden of physical health.