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Japanese Journal of Clinical Oncology 32:506-511 (2002)
© 2002 Foundation for Promotion of Cancer Research

Clinical Factors Associated with Suicidality in Cancer Patients

Tatsuo Akechi1,2, Tomohito Nakano3, Nobuya Akizuki2, Tatsuro Nakanishi2,4, Eisho Yoshikawa2,5, Hitoshi Okamura1,6 and Yosuke Uchitomi1,2,+

1 Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwa, Chiba, 2 Psychiatry Division, National Cancer Center Hospital East, Kashiwa, Chiba, 3 Psychiatry Division, National Cancer Center Hospital, Tokyo, 4 Department of Psychiatry, Kashiwa Hospital, Jikei Medical University, Kashiwa, Chiba, 5 Department of Psychiatry, Chiba Hokuso Hospital, Nippon Medical School, Chiba and 6 Health Science, Hiroshima University School of Medicine, Hiroshima

Background: Previous epidemiological studies have indicated that the risk of suicide in cancer patients is higher than that of the general population. In addition, euthanasia and physician-assisted suicide (PAS) have recently become controversial medical, ethical and legal issues all over the world. Although suicide in cancer patients and appropriate management of cancer patients with suicidality are critical issues in clinical oncology practice, there have been very few studies to understand suicidality in cancer patients. The purpose of this study was to explore the clinical factors associated with suicidality in Japanese patients with cancer.

Methods: We investigated the clinical factors associated with suicidality in cancer patients by analyzing the consultation data of patients referred to the Psychiatry Division, National Cancer Centre Hospital and Hospital East, Japan.

Results: Of 1713 psychiatric referrals, 62 (3.6%) were related to suicidality, including 44 cases with suicidal ideation, 10 suicide attempts and eight cases who had requested euthanasia and/or continuous sedation. Most of the patients suffered from physical distress and/or psychiatric disorders. The results of a multivariate analysis comparing cancer patients with a psychiatric referral related to suicidality and those referred for other reasons indicated that impaired physical functioning and major depression were significant associated factors.

Conclusions: Our findings suggest that early detection and appropriate management of major depression and comprehensive care improving physical functioning may help to prevent suicide and manage suicidality in Japanese cancer patients.

+ For reprints and all correspondence: Yosuke Uchitomi, Psycho-Oncology Division, National Cancer Center Research Institute East, 6–5–1 Kashiwanoha, Kashiwa 277-8577, Japan. E-mail: yuchitom@east.ncc.go.jp


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