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Severe Pain Can Trigger Suicide in Hospital ERs
Date:12/15/2010

By Julia VanTine
HealthDay Reporter

WEDNESDAY, Dec. 15 (HealthDay News) -- A group that accredits many U.S. hospitals has urged hospital and emergency-room caregivers to watch for attempted suicides in patients with no history of psychiatric problems.

The new alert, issued by the Joint Commission, stresses that it's not just psychiatric patients who kill themselves, citing as an example someone recently diagnosed with cancer who goes to an ER because the cancer-related pain has become unbearable.

"A patient who attempts suicide in the emergency room or a hospital's medical or surgical unit often has a different set of presenting complaints or a different diagnosis than a patient hospitalized in a psychiatric unit," said Dr. Robert Wise, a psychiatrist and medical adviser to the commission's division of healthcare quality evaluation.

The alert suggests strategies to help hospitals and ERs reduce the risk for suicide among such patients.

Of the 827 in-hospital suicides reported to the commission since 1995, almost 25 percent occurred in non-psychiatric settings, such as emergency rooms, cancer and intensive-care units and long-term care hospitals, the commission noted. The methods most often used were hanging, suffocation, intentional drug overdose and strangulation.

Because the suicides are reported voluntarily, there's no way to know how common the act is, Wise said. But a hospital in which a suicide occurs examines the circumstances to determine potential causes, "and that's probably more important than the actual prevalence, as it can help to prevent future occurrences," he said.

People with illnesses that cause chronic pain, such as cancer, or that cause a slow mental deterioration, such as dementia, may begin to have thoughts of suicide, he said.

"A patient diagnosed with cancer who is in intense, intractable pain may feel worn out and hopeless, even though they may not talk a
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