Accepted for/Published in: JMIR Research Protocols
Date Submitted: Oct 8, 2020
Date Accepted: Nov 3, 2020
Date Submitted to PubMed: Nov 4, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A single center observational study on the role of demoralization and Meaning in Life in influencing suicidal ideation among patients affected by chronic pain (DEMiL study). The study protocol.
ABSTRACT
Chronic pain is a significant risk factor for suicidal ideation (SI) and suicidal behavior (SB), including a 20-40% prevalence rate of SI, a prevalence between 5-14% of suicidal attempts (SA), and a doubled risk of death by suicide in patients with chronic pain compared to controls. In most studies, associations between chronic pain and suicidality are robust even after adjusting for the effect of socio-demographics and psychiatric comorbidity, and particularly for depressive conditions. A number of specific conditions that can modulate suicidality risk in patients with chronic pain have been investigated, but there is a need for better characterization of other potential risk and protective factors. This project will explore the role of demoralization and Meaning in Life (MiL) constructs in modulating SI in patients with chronic pain. The interest of exploring these constructs in chronic pain patients with SI arises from the common clinical observation that experiencing chronic pain often requires a revision of one’s life goals and expectations. Hence, the impact of chronic pain is not limited to patients’ biopsychosocial functioning, but it affects the existential domain as well. We wish that our project can contribute to a better understanding of the suffering experienced by a person with chronic pain and how this may lead to SI. Concerning clinical implications, the major goals of this study are to: 1) delineate a more precise and individualized suicidal risk profile; 2) improve detection and prevention strategies by investigating SI also in individuals who do not present with a clinically diagnosed depression; and 3) enhance the panel of intervention means by broadening supportive or psychotherapeutic actions. Results of this study will be the basis for a future psychotherapeutic intervention guideline that is oriented towards demoralization and MiL constructs for patients with chronic pain, taking in consideration the existential condition of a person who suffers and strives to deal with his or her pain and suffering.
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