The pain suicidality association: A narrative review

David A. Fishbain, John E. Lewis, Jinrun Gao

Research output: Contribution to journalReview articlepeer-review

45 Scopus citations


Objectives: The objective of this narrative review was to examine recent evidence and, when necessary, past evidence on the association between pain and suicidality. Design: Fifty-eight research reports were found on this topic, which had not previously been reviewed. These reports were divided into groups by whether they addressed suicide ideation (SI), suicide attempts (SAs), or suicide completion (SC), and what population they represented (acute pain patients [APPs], chronic pain patients [CPPs], other than APPs/CPPs) and whether they controlled for relevant confounders. Information as to whether the results of these studies supported/did not support the association of pain and suicidality was abstracted. For each group of studies (above), a vote counting method was utilized to determine the overall percentage of studies supporting/not supporting the association of pain and suicidality. According to this percentage, the consistency of the data supporting this association was rated according to Agency for Healthcare Research and Quality guidelines. Results: The following groups of studies received an A consistency rating (consistent evidence from multiple studies): SI, SA, and SC for other than APPs/CPPs; and SI, SA, and SC for CPP prevalence greater than an appropriate control group. Also, a subgroup of the SI, SA, and SC studies for other than APPs/CPPs had controlled for behavioral issues (potential confounders). These three subgroups also received an A consistency rating. The 58 studies also identified a number of new predictor variables for SI, SA, and SC in CPPs. Conclusions: These studies solidify the evidence for an association between pain and SI, SA, and SC in both CPPs and other than APPs/CPPs.

Original languageEnglish (US)
Pages (from-to)1835-1849
Number of pages15
JournalPain Medicine (United States)
Issue number11
StatePublished - Nov 1 2014
Externally publishedYes


  • Acute pain
  • Acute pain patients
  • Chronic pain
  • Chronic pain patients
  • Pain
  • Review
  • Suicidality
  • Suicide attempts
  • Suicide completion
  • Suicide ideation

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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