Physical Pain and History of Suicidal Behaviors in Alcohol-Dependent Patients Entering Treatment in Poland

ABSTRACT

Background: Individuals with alcohol use disorders have been shown to be at increased risk for suicidal behaviors and chronic pain. Objectives: The aim of this study was to conduct initial analyses of the association between current physical pain and the likelihood of suicidal behavior history in alcohol-dependent patients entering treatment in Poland. Methods: A sample of 366 (73.5% men and 26.5% women) participants were recruited from alcohol treatment centers in Warsaw, Poland. Information was obtained about a history of lifetime suicidal behavior, past 4-week pain level, demographics, social functioning, childhood abuse, depressive symptoms, severity of alcohol and sleep problems. Results: A total of 118 individuals (32.2%) reported at least one suicidal behavior during their lifetime. In unadjusted analyses, there was a significant association between a history of lifetime suicidal behavior and a moderate or greater experience of physical pain during the last four weeks. Other variables that were significantly associated with suicidal behaviors were: younger age, history of childhood abuse, depressive symptoms, sleep problems, consequences of drinking, and lower social support. In the multivariate logistic regression analysis, only experience of moderate or greater pain, age, and depressive symptoms remained significantly associated with a history of suicidal behavior. Conclusions: The experience of physical pain is significantly associated with a lifetime history of suicidal behavior in alcohol-dependent patients. Clinicians should be aware of these associations when conducting assessments and treating alcohol use disorders.

KEYWORDS:

• Alcohol dependence
• physical pain
• suicidal behavior
• depressive symptoms
• childhood abuse

Glossary

• Alcohol dependence: A maladaptive pattern of alcohol use, leading to clinically significant impairment or distress.

• Childhood abuse: The physical, sexual, or emotional maltreatment of a child or children.

• Pain: The physical feeling caused by disease, injury or something that hurts the body.

• Suicide attempt: A serious effort to commit suicide involving definite risk. The outcome frequently depends on circumstances alone and is not under the person's control.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

This study was supported by the National Science Center grant [2012/07/B/HS6/02370; PI: Wojnar], the Polish Ministry of Science and Higher Education grant [2P05D 004 29; PI: Wojnar], the Fogarty International Center/NIDA International Substance Abuse Research Program grant [D43-TW05818; PI: Zucker], the Fogarty International Center/NIAAA International Collaborative Alcohol & Injury Research Training Program grant [D43-TW007569; PI: Blow], National Institute on Alcohol Abuse and Alcoholism grant [R21 AA016104; PI: Brower].

Additional information

Notes on contributors

Andrzej Jakubczyk

Andrzej Jakubczyk, MD, PhD, is Assistant Professor at the Department of Psychiatry, Medical University of Warsaw. His work focuses on description of factors affecting decision making and behavioral control in alcohol-dependent individuals.

Lisham Ashrafioun

Lisham Ashrafioun, PhD, is a post-doctoral fellow at the Department of Veterans Affairs VISN 2 Center of Excellence for Suicide Prevention and Department of Psychiatry at the University of Rochester Medical Center. Dr. Ashrafioun's research interests are related to the intersection between suicidal thoughts and behaviors, substance use, and pain.

Mark Ilgen

Mark Ilgen, PhD, is a clinical psychologist, an investigator with the VA Center for Clinical Management Research (CCMR) in Ann Arbor, Michigan and an Associate Professor in the Department of Psychiatry at the University of Michigan. Much of his current work is focused on methods to improve treatment outcomes in patients with substance use disorders and/or chronic pain. In addition, Dr. Ilgen is interested in evaluating strategies for decreasing the risk of suicide in individuals with alcohol or drug problems.

Maciej Kopera

Maciej Kopera, MD, PhD, is an Associate Professor in the Department of Psychiatry, Medical University of Warsaw. His research focuses primarily on cognitive and emotional processing deficits in addictions.

Anna Klimkiewicz

Anna Klimkiewicz, MD, PhD, is the Assistant Professor at the Department of Psychiatry, Medical University of Warsaw. Her research focuses primarily on risk factors of suicidal behaviors in substance-dependent patients.

Aleksandra Krasowska

Aleksandra Krasowska, MD, PhD, is at the Department of Psychiatry, Medical University of Warsaw. Dr Krasowska's research focuses primarily on associations between alcohol use and behavioral control, especially in the context of sexual preference disorders.

Malgorzata Solowiej

Małgorzata Solowiej, MD, PhD, is candidate at the Medical University of Warsaw. Her research interests focus on risky behaviors and emotional processing in alcohol dependence.

Kirk J. Brower

Kirk J. Brower, MD, is a Professor of Psychiatry at the University of Michigan (UM) and Executive Director of the UM Addiction Treatment Services. His research interests include the relationship between alcohol dependence and sleep, addiction pharmacotherapy, and predictors of treatment outcome for alcohol use disorders. In addition, he currently focuses on physician health.

Marcin Wojnar

Marcin Wojnar, MD, PhD, is Professor of Psychiatry, Chair of the Department of Psychiatry, Medical University of Warsaw. Most of his current research work is focused on biological and psychosocial risk factors, correlates and predictors of course and treatment outcomes in substance-use disorders.