Abstract
Suicidal ideation, which can occur in oncology patients, is associated with suffering and a reduced quality of life. Empirical studies indicate that the incidence of suicide in people with cancer is approximately twice that of the general population. Objective: This cross-sectional descriptive study was designed to establish the prevalence of suicidal ideation in adult oncology patients based on a combination of scales to measure this variable. Method: A battery of three instruments (Scale for Suicidal Ideation. Item 9 of Beck’s Depression Inventory, and a semi-structured interview) was used to make estimates that are not based on just one test and can thus make a comprehensive evaluation of suicidal ideation in the study sample. Four approximations, based on different items from suicidal ideation assessment scales, were developed to determine the most sensitive combination for identifying the presence of suicidal ideation in adult cancer patients. Results: The highest prevalence of suicidal ideation found with the proposed scales was 24.5% (CI = 16%-33%) with Scale 1; 23.6% (CI = 15.2%-32%) with Scale 2; and 19.1% (CI = 11.3%-26.9%) with Scale 4. The lowest prevalence of suicidal ideation was 17.3% (CI = 9.8%-24.8%) with Scale 3. Conclusions: Suicidal behavior in the oncology patient should be assessed; however, there is a need to select sensitive instruments that can be applied easily and are suitable for the target group, which faces difficulties in participating in extensive evaluations.
Highlights
Studies about suicidal behavior in people with cancer are few
It was found that the highest prevalence of suicidal ideation with the original scales was 17.3 (CI = 9.8% - 24.8%) based on the Scale for Suicidal Ideation (SSI); while the lowest prevalence was 4.5% (CI = 1.5% - 10.3%) with Item 9 of the Beck’s Depression Inventory (BDI)-1A (Figure 1)
Using the complete SSI as a reference, it is possible to state that given that the confidence-interval overlap, it is possible to use any of the proposed scales or items from the Intv. and the SSI to assess suicidal ideation
Summary
Studies about suicidal behavior in people with cancer are few. The study by Robson et al showed that the mortality rate from completed suicides in this population ranges from 1 - 11 [1]. These authors found that while suicidal ideation in the general population had a prevalence ranging from 1.1% - 19.8%, it ranged from 0.8% - 71.4% in the oncology population. Studies concur that the incidence of suicide in people with cancer is approximately double that of the general population [3,4]. The same studies suggest that the risk of suicide is greater in men with cancer and increases with age, the same as in the general population; male patients over 65 have higher rates of suicide, reaching the highest levels after the age of 80
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