medigraphic.com
ISSN 0185-3325 (Print)
Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2022, Number 2

<< Back

Salud Mental 2022; 45 (2)

Suicide in cancer patients undergoing palliative care: A report of two cases

Ascencio HL, Rodríguez-Mayoral O, García-Salamanca MF, Monreal-Carrillo E, Allende-Pérez S

Language: English
References: 37
Page: 89-93
PDF size: 160.35 Kb.


ABSTRACT

Introduction. Suicide represents a major public health problem worldwide, and cancer patients might have vulnerability factors which increase suicide risk. There are multiple factors associated with this tragic outcome, including those stemming from the disease itself, mental illness and social, personal and spiritual factors. Although previous reports have identified a suicide rate which ranges from .03-7% among cancer patients undergoing palliative care, this has not been studied in Mexico. Objective. This study sought to report the cases of suicide in patients with cancer undergoing palliative care at a large cancer reference center. Method. A retrospective review of records was performed between 2018-2019 for patients treated at the Palliative Care Service of the Instituto Nacional de Cancerología in Mexico City. Records for patients who committed suicide were reviewed to describe factors associated with this outcome. Results. Among all deaths identified during the record review, two were due to suicide (.09%). The patients were one female and one male, 60 and 42 years of age, diagnosed with breast cancer and gastroesophageal junction cancer, respectively, associated with tobacco and alcohol consumption, as well as several economic, social, and familial stress factors. One of the patients was identified as likely having major depressive disorder. Discussion and conclusion. Deaths might be underreported in our population. A systematic evaluation is required in order to establish and detect suicidal behavior risk factors, and a follow-up plan for all these patients.


REFERENCES

  1. Allende-Pérez, S., Verástegui-Avilés, E., Chavira-Estefan, S., Tejeida-Bautista, L.,& Domínguez-Ocadio, G. (2013). ¿Cuándo referir a un paciente con cáncer acuidados paliativos? Gaceta Mexicana de Oncología, 12(4), 280-285.

  2. Amiri, S., & Behnezhad, S. (2019). Cancer Diagnosis and Suicide Mortality: ASystematic Review and Meta-Analysis. Archives of Suicide Research, 24(sup2),S94-S112. doi: 10.1080/13811118.2019.1596182

  3. Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention:The Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology,

  4. 47(2), 343-352. doi: 10.1037//0022-006x.47.2.3434. Bellido-Pérez, M., Crespo, I., Wilson, K. G., Porta-Sales, J., Balaguer, A., &Monforte-Royo, C. (2018). Assessment of the wish to hasten death in patientswith advanced cancer: A comparison of 2 different approaches. Psycho-Oncology, 27(6), 1538-1544. doi: 10.1002/pon.4689

  5. Borges, G., Orozco, R., Benjet, C., & Medina-Mora, M. E. (2010). [Suicide andsuicidal behaviors in Mexico: Retrospective and current status]. Salud PúblicaMéxico, 52(4), 292-304.

  6. Carreira, H., Williams, R., Müller, M., Harewood, R., Stanway, S., & Bhaskaran,K. (2018). Associations Between Breast Cancer Survivorship and AdverseMental Health Outcomes: A Systematic Review. Journal of the National CancerInstitute, 110(12), 1311-1327. doi: 10.1093/jnci/djy177

  7. Choi, J. W., & Park, E.-C. (2020). Suicide risk after cancer diagnosis among olderadults: A nationwide retrospective cohort study. Journal of Geriatric Oncology,11(5), 814-819. doi: 10.1016/j.jgo.2019.11.006

  8. Choy, C. H.-L. (2017). Suicide in palliative care setting. Annals of PalliativeMedicine, 6(Suppl 2), S264-S265. doi: 10.21037/apm.2017.07.02

  9. Departamento de Bioestadística. (2020). Información estadística. Instituto Nacionalde Cancerología.

  10. Du, L., Shi, H.-Y., Yu, H.-R., Liu, X.-M., Jin, X.-H., Yan-Qian, … Chen, H.-L.(2020). Incidence of suicide death in patients with cancer: A systematic reviewand meta-analysis. Journal of Affective Disorders, 276, 711-719. doi: 10.1016/j.jad.2020.07.082

  11. Fan, W., Yang, H., Sun, Y., Zhang, J., Li, G., Zheng, Y., & Liu, Y. (2017). Ketaminerapidly relieves acute suicidal ideation in cancer patients: A randomizedcontrolled clinical trial. Oncotarget, 8(2), 2356-2360. doi: 10.18632/oncotarget.13743

  12. Fernández-Niño, J. A., Astudillo-García, C. I., Bojorquez-Chapela, I., Morales-Carmona, E., Montoya-Rodriguez, A. A., & Palacio-Mejia, L. S. (2016). TheMexican Cycle of Suicide: A National Analysis of Seasonality, 2000-2013.PLOS ONE, 11(1), e0146495. doi: 10.1371/journal.pone.0146495

  13. Filiberti, A., Ripamonti, C., Totis, A., Ventafridda, V., De Conno, F., Contiero, P.,& Tamburini, M. (2001). Characteristics of Terminal Cancer Patients WhoCommitted Suicide During a Home Palliative Care Program. Journal of Pain andSymptom Management, 22(1), 544-553. doi: 10.1016/S0885-3924(01)00295-0

  14. Grunebaum, M. F., Galfalvy, H. C., Choo, T.-H., Keilp, J. G., Moitra, V. K., Parris,M. S., … Mann, J. J. (2018). Ketamine for Rapid Reduction of SuicidalThoughts in Major Depression: A Midazolam-Controlled Randomized ClinicalTrial. American Journal of Psychiatry, 175(4), 327-335. doi: 10.1176/appi.ajp.2017.17060647

  15. Grzybowska, P., & Finlay, I. (1997). The incidence of suicide in palliative care patients.Palliative Medicine, 11(4), 313-316. doi: 10.1177/026921639701100408

  16. Gutiérrez-García, A. G., Contreras, C. M., & Orozco-Rodríguez, R. C. (2006). Elsuicidio, conceptos actuales. Salud Mental, 29(5), 66-74.

  17. Henson, K. E., Brock, R., Charnock, J., Wickramasinghe, B., Will, O., & Pitman, A.(2019). Risk of Suicide After Cancer Diagnosis in England. JAMA Psychiatry,76(1), 51-60. doi: 10.1001/jamapsychiatry.2018.3181

  18. Hinrichs, K. L. M., Steadman-Wood, P., & Meyerson, J. L. (2020). ACT Now: TheIntersection of Acceptance and Commitment Therapy with Palliative Care in aVeteran with Chronic Suicidal Ideation. Clinical Gerontologist, 43(1), 126-131.doi: 10.1080/07317115.2019.1642974

  19. Hopko, D. R., Armento, M. E. A., Robertson, S. M. C., Ryba, M. M., Carvalho, J.P., Colman, L. K., … Lejuez, C. W. (2011). Brief behavioral activation andproblem-solving therapy for depressed breast cancer patients: Randomized trial.Journal of Consulting and Clinical Psychology, 79(6), 834-849. doi: 10.1037/a0025450

  20. Hopko, D. R., Funderburk, J. S., Shorey, R. C., McIndoo, C. C., Ryba, M. M.,File, A. A., … Vitulano, M. (2013). Behavioral Activation and Problem-Solving Therapy for Depressed Breast Cancer Patients: Preliminary Supportfor Decreased Suicidal Ideation. Behavior Modification, 37(6), 747-767. doi:10.1177/0145445513501512

  21. Kawashima, Y., Yonemoto, N., Inagaki, M., Inoue, K., Kawanishi, C., & Yamada,M. (2019). Interventions to prevent suicidal behavior and ideation for patientswith cancer: A systematic review. General Hospital Psychiatry, 60, 98-110. doi:10.1016/j.genhosppsych.2019.07.003

  22. Keaton, S. A., Madaj, Z. B., Heilman, P., Smart, L., Grit, J., Gibbons, R., … Brundin,L. (2019). An inflammatory profile linked to increased suicide risk. Journal ofAffective Disorders, 247, 57-65. doi: 10.1016/j.jad.2018.12.100

  23. Kolva, E., Hoffecker, L., & Cox-Martin, E. (2020). Suicidal ideation in patientswith cancer: A systematic review of prevalence, risk factors, interventionand assessment. Palliative & Supportive Care, 18(2), 206-219. doi: 10.1017/S1478951519000610

  24. Kumar, V., Chaudhary, N., Soni, P., & Jha, P. (2017). Suicide Rates in Cancer Patientsin the Current Era in United States. American Journal of Psychiatry Residents’Journal, 12(1), 11-14. doi: 10.1176/appi.ajp-rj.2017.120104

  25. Lee, Y. J., Kim, C.-M., Linton, J. A., Lee, D. C., Suh, S.-Y., Seo, A.-R., & Ahn,H.-Y. (2013). Association between Spiritual Well-Being and Pain, Anxietyand Depression in Terminal Cancer Patients: A Pilot Study. The KoreanJournal of Hospice and Palliative Care, 16(3), 175-182. doi: 10.14475/kjhpc.2013.16.3.175

  26. Mondragón, L., Saltijeral, M. T., Bimbela, A., & Borges, G. (1998). La ideaciónsuicida y su relación con la desesperanza, el abuso de drogas y alcohol. SaludMental, 21(5), 20-27.

  27. Monforte-Royo, C., González-de Paz, L., Tomás-Sábado, J., Rosenfeld, B., Strupp,J., Voltz, R., & Balaguer, A. (2017). Development of a short form of the Spanishschedule of attitudes toward hastened death in a palliative care population.Quality of Life Research, 26(1), 235-239. doi: 10.1007/s11136-016-1409-0

  28. Oken, M. M., Creech, R. H., Tormey, D. C., Horton, J., Davis, T. E., McFadden,E. T., & Carbone, P. P. (1982). Toxicity and response criteria of the EasternCooperative Oncology Group. American Journal of Clinical Oncology, 5(6),649-655.

  29. O’Connor, M., Groom, J., Watson, M., & Harris, P. (2016). Developing OrganizationalGuidelines for the Prevention and Management of Suicide in Clients and CarersReceiving Palliative Care in Australia. American Journal of Hospice andPalliative Medicine, 33(3), 252-255. doi: 10.1177/1049909114565659

  30. Rodríguez-Mayoral, O., Ascencio-Huertas, L., Verástegui, E., Delgado-Guay, M. O.,& Allende-Pérez, S. (2019a). The desire to hasten death in advanced cancerpatients at a Mexican palliative care service. Salud Mental, 42(3), 103-109. doi:10.17711/SM.0185-3325.2019.014

  31. Rodríguez-Mayoral, O., Pérez-Esparza, R., Domínguez-Ocadio, G., & Allende-Pérez,S. (2020). Ketamine as augmentation for the treatment of major depression andsuicidal risk in advanced cancer: Case report. Palliative & Supportive Care,18(1), 110-112. doi: 10.1017/S1478951519000580

  32. Rodríguez-Mayoral, O., Rodríguez-Ortíz, B., Ascencio-Huertas, L., Peña-Nieves, A.,Verástegui, E., Allende-Pérez, S., & Lloyd-Williams, M. (2019b). Validation ofthe Brief Edinburgh Depression Scale (BEDS) in a Mexican population withadvanced cancer in a palliative care service. Palliative & Supportive Care,17(4), 436-440. doi: 10.1017/S1478951518000640

  33. Saxena, S., Krug, E. G., Chestnov, O., & World Health Organization, Eds. (2014).Preventing suicide: A global imperative. Geneva: World Health Organization.

  34. Sullivan, D. R., Forsberg, C. W., Golden, S. E., Ganzini, L., Dobscha, S. K., &Slatore, C. G. (2018). Incidence of Suicide and Association with Palliative Careamong Patients with Advanced Lung Cancer. Annals of the American ThoracicSociety, 15(11), 1357-1359. doi: 10.1513/AnnalsATS.201805-299RL

  35. Thekkumpurath, P., Walker, J., Butcher, I., Hodges, L., Kleiboer, A., O’Connor, M.,… Sharpe, M. (2011). Screening for major depression in cancer outpatients: Thediagnostic accuracy of the 9-item patient health questionnaire. Cancer, 117(1),218-227. doi: 10.1002/cncr.25514

  36. Zaorsky, N. G., Zhang, Y., Tuanquin, L., Bluethmann, S. M., Park, H. S., & Chinchilli,V. M. (2019). Suicide among cancer patients. Nature Communications, 10(1),207. doi: 10.1038/s41467-018-08170-1

  37. Zhang, Y., Law, C. K., & Yip, P. S. F. (2011). Psychological factors associatedwith the incidence and persistence of suicidal ideation. Journal of AffectiveDisorders, 133(3), 584-590. doi: 10.1016/j.jad.2011.05.003




2020     |     www.medigraphic.com