Suicide Risk Factors and Prevention in Cancer Patients
Generally suicide is defined as a voluntary intentional action, on occasion – as an impulsive, sudden and not planned act. Since 1993, Lithuania has had the highest suicide rates in the world among men and topped the ranking of women’s suicide rates in Europe. Despite promising progress in oncology health care services, the data of foreign authors indicate suicide being more prevalent among cancer patients than among the general population. At this moment, data on the incidence of suicide among cancer patients in Lithuania are not available. The aim of the literature analysis was to identify the main suicide risk factors and consider aspects significant to the prevention of suicide in cancer patients. METHODS. The review was based on the recent literature obtained through a PubMed search (covering period from February 2001 to January 2011). During the first screen, 483 potentially eligible citations were identified, and 35 articles met the eligibility criteria for this review and were retrieved. RESULTS. In various literature sources a described about 60 suicide risk factors. Depression has been identified as the main and most prevalent suicide risk factor, whereas cases of other mental pathology have been regarded as less common. Experienced symptoms such as pain, dyspnea, or reduced physical activity play a significant role in the risk of suicide. Tumor localization and post-diagnostic period are also influential on suicide risk. Suicide is induced by demographic, social, and economic factors both in cancer patients and the general population. A long-term and regular care, corresponding to the needs of patients at risk, must be available and patients’ close people should be involved. However, medical staffs, working with cancer patients, do not feel very strong in assessing and managing patients’ psycho-emotional problems, among them suicide intentions. In some studies it was vindicated that poor psychological knowledge and lack of consulting skills of medical staff improves suicidal risk of the patients, so it is crucial that every health care specialist could assess suicidal risk and react effectively. CONCLUSIONS. Cancer patient’s suicide should be characterized as an interdependent network of numerous, diverse circumstances rather than an isolated cause. As no single factor is universally causal, no single intervention will prevent all suicides. United, easily applied, and patient-orientated system for the evaluation of suicide risk of cancer patients is crucial improving psycho-emotional health of cancer patients.