Suicidality in chronic abdominal pain: an analysis of the Hispanic Health and Nutrition Examination Survey (HHANES).

The objective of this study was to explore the relationship between suicidal ideation, suicidal attempts, depression and chronic abdominal pain in data gathered during a systematic epidemiologic survey, the Hispanic Health and Nutrition Examination Survey of the United States National Centre for Health Statistics. The material comprises data collected between 1982 and 1984 in samples of Hispanic groups in the United States. A sub-sample which initially comprised 5498 subjects had provided answers to questions concerning the thoughts about death, wishes to die, thoughts of committing suicide and suicide attempts, as well as information about complaints of chronic abdominal pain and responses to the Centre for Epidemiologic Studies Depression Scale (CES-D). Complete answers were available from 4964 subjects. The data were analyzed by tabulation, and logistic regression analyses. The lifetime prevalence of suicidality was much increased in subjects with pain compared with those without chronic abdominal pain. Rates for thoughts about death, wishing to die, suicidal ideation and suicide attempts were 2- to 3-times more frequent in those with chronic abdominal pain compared with those without. Logistic regression analyses and the calculation of odds ratios confirmed that the most powerful predictive factors for suicidality were first, the presence of significant depressive ideation, and second, the presence of chronic abdominal pain. There is a strong relationship between chronic abdominal pain and suicidality in the Hispanic population in the United States. This was particularly evident in the Puerto Rican population of the United States where both rates were much increased compared with other Hispanic citizens. The present data are new, but no conclusion can be drawn concerning causality because they are cross-sectional. They indicate the importance of the link between chronic abdominal pain and depression in this population.