Risk and predictors of attempted and completed suicide in patients with hematological malignancies

Abstract

Background: Hematological malignancies can cause high levels of distress, but few studies have assessed risk of suicidal behavior among these patients.

Methods: We evaluated risk of attempted and completed suicide in a cohort of 46,309 patients diagnosed with malignant lymphoma, myeloma and leukemia in Sweden 1992 to 2009 and 107,736 cancer-free subjects, using Poisson regression.

Results: In all, 146 suicide attempts and 63 completed suicides occurred during a median follow up of 3.1 years (maximum 19 years). The risk of completed suicide was 3.5-fold increased among patients with myeloma [incidence rate ratio (IRR) = 3.52, 95% confidence interval (CI) = 2.05-6.03] and 1.9-fold increased among patients with lymphoma (IRR = 1.87, 95% CI = 1.31-2.67) but not significantly increased among patients with leukemia. Risk of attempted suicide was increased among patients with myeloma (IRR = 2.13, CI = 1.39-3.26) and lymphoma (IRR = 1.34, 95% CI = 1.07-1.69). Both male and female patients were at increased risk of attempted as well as completed suicide. A pre-malignant history of mental disorders conferred 15-fold to 30-fold increased risks, but elevated risks were also observed among patients without such history.

Conclusions: Suicidal actions in patients with hematological malignancies have high suicidal intent, and that subgroups of patients should be monitored for suicidal ideation.

Keywords: cancer; leukemia; lymphoma; myeloma; oncology; suicide.