Cancer Patients’ Suicide Risk Tied to Physical Functioning

Depression, not surprisingly, is a risk factor for suicide among cancer patients, just as it is for so many other people. But why do some depressed cancer patients contemplate suicide while others do not? Yosuke Uchitomi, M.D., Ph.D., a psycho-oncologist with the National Cancer Center Research Institute East in Kashiwa, Japan, and his coworkers launched a study to find out.

They focused on 220 cancer patients who had been referred to the National Cancer Center Hospital’s psychiatric division and who were found, according to DSM-IV criteria, to be suffering from a major depression. Yet only about one-half—113—had suicidal ideation. Uchitomi and his colleagues then compared psychiatric consultation data for the 113 with psychiatric consultation data for the 107 to see whether they could determine why some depressed cancer patients considered suicide, whereas others did not.

As they reported in the March/April Psychosomatics, physical pain did not appear to be the answer—nor did the kind of cancer or how far it was advanced. However, poor physical functioning appeared to be one explanation, and severe depression an even greater one.

But why were certain cancer patients so severely depressed? Might it have been because of loss of physical function? Uchitomi and his colleagues think this is a possibility since a lack of physical functioning has been linked with depression in cancer patients. In fact, they pointed out, loss of control of bodily function is a major reason why patients, including cancer patients, request suicide assistance in Oregon (the only state in the United States that has legalized physician-assisted suicide).

The study, “Why Do Some Cancer Patients With Depression Desire an Early Death and Others Do Not?,” is posted on the Web at psy.psychiatryonline.org/cgi/content/full/42/2/141?. ▪