mardi 10 novembre 2015

RECHERCHE ETUDE L'impact de la douleur physique sur les pensées et comportements suicidaires: méta-analyses

L'impact de la douleur physique sur les pensées et comportements suicidaires: méta-analyses
Journal of Psychiatric Research Volume 71, December 2015, Pages 16–32
Review
Titre original : The impact of physical pain on suicidal thoughts and behaviors: Meta-analyses
Raffaella Calatia, b, c, , , Camelia Laglaoui Bakhiyia, b, d, Sylvaine Arteroa, Mark Ilgene, f, Philippe Courteta, b, c
a INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France
b Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
c FondaMental Foundation, France
d Psychiatric Unit, CHU Casablanca, Hassan II University, Casablanca, Morocco
e VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
f University of Michigan Department of Psychiatry, Ann Arbor, MI, USA
Received 22 June 2015, Revised 11 August 2015, Accepted 10 September 2015, Available online 11 September 2015
Corresponding author. Inserm U 1061, Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, 39, avenue Charles Flahault, 34093 Montpellier cedex 5, France.

Sujet de l'étude : L'impact de la douleur physique sur les pensées et comportements suicidaires: méta-analyses
Bien que la relation entre la douleur physique et les pensées suicidaires et les comportements a été exploré dans plusieurs études épidémiologiques et cliniques, il est encore loin d'être bien compris. Par conséquent, l'étude a effectué une méta-analyse d'études comparant les taux de pensées et comportements suicidaires chez les personnes avec et sans douleur physique.
Recherche sur articles de MEDLINE et PsycINFO (mai 2015), des études comparant les taux de pensées suicidaires actuelles et au courant de la vie et comportements suicidaires chez les individus avec tout type de douleur physique par rapport à ceux sans douleur.
D'après l'étude la douleur physique est un facteur de risque cohérent pour les pensées et comportements suicidaires. Néanmoins de plus amples recherches sont nécessaires pour déterminer l'impact spécifique de: 1) contre la douleur aiguë chronique, 2) différents types de douleur (par exemple, douleurs inexpliquées médicalement ), et 3) les facteurs de risque de suicide chez les patients souffrant de douleurs chroniques. 

Abstract
Although the relationship between physical pain and suicidal thoughts and behaviors has been explored in multiple epidemiologic and clinical studies, it is still far from being well understood. Consequently, we conducted a meta-analysis of studies comparing rates of suicidal thoughts and behaviors in individuals with and without physical pain.
We searched MEDLINE and PsycINFO (May 2015) for studies comparing rates of current and lifetime suicidal thoughts and behaviors (death wish, suicide ideation, plan, attempt and death: DW, SI, SP, SA, SD) in individuals with any type of physical pain (headache, back, neck, chest, musculoskeletal, abdominal and pelvic pains, arthritis, fibromyalgia, medically unexplained pain, and other not specified pain) versus those without it. Data were analyzed with Cochrane Collaboration Review Manager Software (RevMan, version 5.3). We assessed the methodological quality of the studies with the STROBE statement.
Of the 31 included studies, three focused on lifetime DW, twelve focused on current SI (six lifetime), six focused on current SP (two lifetime), nine focused on current SA (11 lifetime) and eight on SD. Individuals with physical pain were more likely to report lifetime DW (p = 0.0005), both current and lifetime SI (both p < 0.00001), SP (current: p = 0.0008; lifetime: p < 0.00001), and SA (current: p < 0.0001; lifetime: p < 0.00001). Moreover, they were more likely to report SD (p = 0.02). In all analyses, the between study heterogeneity was high. Moreover, the presence of publication bias has been detected in the main outcomes.
Physical pain is a consistent risk factor for suicidal thoughts and behaviors. Further research is required to investigate the specific impact of: 1) chronic versus acute pain, 2) different types of pain (e.g., medically unexplained pain), and 3) risk factors for suicide in chronic pain patients.
Keywords Pain; Suicidal thoughts; Suicidal behaviors; Meta-analysis

Autres articles liés
Correspondence  Framing the impact of physical pain on suicide attempts. A reply to stubbs
 Raffaella Calati, Psy.D. Ph.D., ·INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France. Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France .  FondaMental Foundation, France
Sylvaine Artero, Ph.D.  INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France
Philippe Courtet, MD Ph.D. INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France .   Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France  FondaMental Foundation, France
Jorge Lopez-Castroman.  INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France ,  Department of Adult Psychiatry, CHRU Nimes, Nimes, France
Journal of Psychiatric Research  Available online 28 October 2015 Received 23 October 2015, Accepted 26 October 2015, Available online 28 October 2015

Références de l'article concerné  : Stubbs B. The prevalence and odds of suicidal thoughts, behaviours and deaths among peoplewith painful comorbidities: An updated meta-analysi s accounting for publication bias. Journal of psychiatric research.
http://www.sciencedirect.com/science/article/pii/S0022395615003155


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