Table_1_Prevalence of suicidal behavior in patients with chronic pain: a systematic review and meta-analysis of observational studies.docx

ObjectiveChronic pain is a leading cause of disability, severely impairing an individual’s daily activity and quality of life. In addition, this condition may contribute to suicidal thoughts by leading to neuropsychological impairments, a perceived lack of meaning in life, and pain-related catastrophizing. This systematic review aimed to comprehensively investigate the prevalence and associated factors of suicidal behaviors (SBs) including suicidal ideation (SI) and suicide attempt (SA) or its complete, in individuals with chronic pain.
MethodsFive electronic databases were searched up to October 4, 2022. Only observational studies investigating the prevalence of SB in individuals with chronic pain were included. The methodological quality of the included studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. A meta-analysis was conducted to quantify the prevalence of SB in the population, and the command “Metaprop” was used in STATA/MP 16. In addition, factors explaining the association between chronic pain and SB identified through regression analysis were investigated.
ResultsA total of 19 studies were included in this review (N = 3,312,343). The pooled lifetime prevalence of SI and SA was 28.90% (95% confidence interval, 17.95 to 41.26%) and 10.83% (5.72 to 17.30%), respectively, in a mixed sample comprising various chronic pain conditions. Importantly, the pooled prevalence of past 2-week SI was as high as 25.87% (18.09 to 34.50%). The methodological quality of the included studies was not optimal, and studies using validated SB assessment tools were lacking. Potential protective factors against SB in this population included pain coping and self-efficacy, older age, certain race/ethnicity groups, and marriage.
ConclusionThis systematic review and meta-analysis demonstrated the high prevalence of SB in individuals with chronic pain. Specifically, around 1 in 4 individuals with chronic pain had SI within the last 2 weeks. However, there was considerable heterogeneity in the pooled prevalence of SB in this population.

研究目的：慢性疼痛是致残的首要诱因，可严重损害个体的日常活动能力与生活质量。此外，该病症可通过引发神经心理功能损害、生命意义感缺失以及疼痛相关灾难化思维，增加自杀意念的产生风险。本系统综述旨在全面探讨慢性疼痛患者自杀行为（suicidal behaviors, SB），涵盖自杀意念（suicidal ideation, SI）与自杀未遂（suicide attempt, SA）乃至完全性自杀的患病率及其相关影响因素。
研究方法：本研究检索了截至2022年10月4日的5个电子数据库，仅纳入探讨慢性疼痛患者自杀行为患病率的观察性研究。采用《加强流行病学观察性研究报告规范》（Strengthening the Reporting of Observational Studies in Epidemiology, STROBE）评估纳入研究的方法学质量。通过Meta分析量化该人群自杀行为的患病率，在STATA/MP 16软件中使用"Metaprop"命令进行分析。此外，本研究还探讨了经回归分析识别出的慢性疼痛与自杀行为之间关联的影响因素。
研究结果：本综述共纳入19项研究，总样本量为3,312,343。在涵盖多种慢性疼痛病症的混合样本中，自杀意念与自杀未遂的合并终生患病率分别为28.90%（95%置信区间：17.95~41.26%）与10.83%（5.72~17.30%）。值得注意的是，近2周自杀意念的合并患病率高达25.87%（18.09~34.50%）。纳入研究的方法学质量欠佳，且缺乏采用经过验证的自杀行为评估工具的相关研究。该人群中自杀行为的潜在保护因素包括疼痛应对方式与自我效能感、高龄、特定种族/族裔群体以及婚姻状况。
研究结论：本系统综述与Meta分析结果显示，慢性疼痛患者的自杀行为患病率较高。具体而言，约四分之一的慢性疼痛患者在近2周内出现自杀意念。然而，该人群自杀行为的合并患病率存在显著异质性。