The role of physical and mental health multimorbidity in the risk of suicidal thoughts and behaviours

Kavalidou, Aikaterini (2018) The role of physical and mental health multimorbidity in the risk of suicidal thoughts and behaviours. PhD thesis, University of Glasgow.

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Background: The effects of physical illness and psychiatric disorders have been extensively investigated in fatal and non-fatal suicidal behaviour.
Although different study designs have focused on the independent roles of physical and mental illness in suicidality, few studies have examined the relationship between co-occurring physical and mental health conditions (multimorbidity) and suicide risk. Considering the paucity of research, the present doctoral programme of research aimed to investigate if populations with physical/mental multimorbidity have an increased risk of suicidal thoughts and behaviours, compared to those with neither physical nor mental health conditions, and further investigate if this effect is stronger than either of the health conditions alone.
Methods: Based on the well-established terms of comorbidity and multimorbidity, the effect of co-occurring health conditions in the risk of suicidality was investigated by undertaking an overview of reviews and a systematic review. Four empirical studies of existing datasets were conducted in order to explore if suicidality (suicidal thoughts and suicide attempts) varies as a function of physical/mental multimorbidity. Two national mental health surveys from the United Kingdom (National Psychiatric Morbidity Survey 2000, n = 8575; Adult Psychiatric Morbidity Survey 2007, n = 7389) and one cohort study carried out in Scotland (West of Scotland Twenty-07 study, n = 4510) were used and both cross-sectional and prospective study designs were employed.
Results: Findings indicated that those with physical/mental multimorbidity are more likely to have suicidal thoughts and attempt suicide, compared to those with neither physical nor mental health conditions. The results were consistent: having both physical and mental health conditions did not increase risk of suicidal thoughts or attempts, beyond the risk conferred by mental illness alone. Having only physical health conditions was not associated with either suicidal thoughts or suicide attempts.
Conclusions: Overall, the findings suggest a potential risk of suicidality for populations with physical/mental multimorbidity. Although multimorbidity was a predictor of suicidality, it did not increase the risk of any suicide-related outcome more than mental health conditions alone. The current findings highlight that health care professionals should focus on populations who have reached services for non-mental health issues, but subsequently develop mental illness, as this pattern of multimorbidity could potentially be a risk factor for suicidal thoughts and behaviours. Further research is needed to better understand the risk of suicide in individuals with physical/mental multimorbidity.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Keywords: Multimorbidity, suicidal thoughts, suicide attempts, physical, mental, health conditions.
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
Funder's Name: Economic and Social Research Council (ESRC)
Supervisor's Name: O'Connor, Professor Rory C. and Smith, Professor Daniel J.
Date of Award: 2018
Depositing User: Aikaterini Kavalidou
Unique ID: glathesis:2018-30677
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 24 Jul 2018 09:49
Last Modified: 30 Aug 2018 07:43
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