Miller V et al. (2004) Suicidal ideation in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol 2: 1064–1068
Suicidal thoughts are a common consequence of chronic disease, but there is little information about how this problem affects patients with irritable bowel syndrome (IBS). Miller and colleagues have addressed this question in their recent study in the UK.
The study analyzed data from 300 IBS patients being treated in the tertiary, secondary or primary care systems, with 100 patients in each category. A further 100 patients with inflammatory bowel disease (IBD)—regarded as a more serious condition—were analyzed as a comparator for IBS patients in tertiary care. Using an anonymized questionnaire, the authors asked whether patients had ever seriously considered or attempted suicide because of their bowel symptoms.
Suicidal thoughts specifically relating to IBS were more common among patients in the tertiary care system (38%) than in patients in secondary (16%) or primary care (4%); the differences between the three groups were statistically significant and corresponded to an increasing severity of symptoms as patients progressed from primary to tertiary care. These feelings had led to suicide attempts in 5% of patients in the tertiary care group. In the IBD group, 15% of patients had considered suicide because of their condition and one patient had attempted suicide. This suggests that the rate of suicide ideation among IBS patients is particularly high. Although depression was a significant predictor of suicidal thoughts, symptom severity and anxiety were also revealed as important factors.
Miller et al. observe that it is important to identify patients suffering from feelings of hopelessness and despair, and to provide counseling or other treatment to alleviate these problems.