Abstract

Objective

Effective suicide prevention is hindered by a limited understanding of the neurobiology leading to suicide. We aimed to examine the association between changes in the experience of pain and disturbances in sleep quantity and quality in patients with elevated risk for suicide.

Methods

Three groups of adult depressed individuals, including patients following a recent suicide attempt (n = 79), patients experiencing current suicidal ideation (n = 131), and patients experiencing depression but no suicidal ideation or behavior in at least 6 months (n = 51), were examined in a case-control study for sleep quantity and quality, physical and psychological pain, pressure pain threshold, suicidal ideation, and recent suicidal behavior.

Results

Sleep quality, physical and psychological pain were positively associated with suicidal ideation severity. In both cases in which sleep quality was added to a model with either physical or psychological pain, physical or psychological pain became more significantly associated with suicidal ideation severity. Pressure pain threshold was elevated in patients suffering from any type of insomnia. There was no significant association between pressure pain threshold and suicidal ideation severity.

Conclusions

The impact of these findings lies in the identification of both psychological and physical pain, and sleep quality as potential biological mechanisms underlying suicidal risk.

• HIGHLIGHTS

• We assessed the association between pain and sleep quality in suicidal patients.

• Sleep quality, physical and psychological pain were associated with suicide risk.

• Pain perception may mediate the progression to suicidal behavior.

中文翻译：

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疼痛体验与睡眠质量差和自杀风险增加密切相关

摘要

客观的

对导致自杀的神经生物学了解有限，阻碍了有效的自杀预防。我们的目的是检查自杀风险升高的患者疼痛体验的变化与睡眠数量和质量的紊乱之间的关联。

方法

三组成年抑郁症患者，包括最近自杀未遂的患者（n  = 79）、当前有自杀意念的患者（n  = 131）和至少 6 个月内出现抑郁但没有自杀意念或行为的患者（n  = 51 )，在一项病例对照研究中对睡眠数量和质量、生理和心理疼痛、压力痛阈、自杀意念和近期自杀行为进行了检查。

结果

睡眠质量、生理和心理疼痛与自杀意念严重程度呈正相关。在将睡眠质量添加到具有身体或心理疼痛的模型中的两种情况下，身体或心理疼痛与自杀意念严重程度的相关性变得更加显着。患有任何类型失眠症的患者的压力痛阈值均升高。压力痛阈值与自杀意念严重程度之间没有显着关联。

结论

这些发现的影响在于将心理和身体疼痛以及睡眠质量确定为潜在的自杀风险的生物学机制。

• 强调

• 我们评估了自杀患者的疼痛与睡眠质量之间的关联。

• 睡眠质量、身体和心理疼痛与自杀风险相关。

• 疼痛感知可能介导自杀行为的进展。