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Suicide and suicidality in somatic symptom and related disorders: A systematic review
Journal article   Peer reviewed

Suicide and suicidality in somatic symptom and related disorders: A systematic review

Michael E Torres, Bernd Löwe, Samantha Schmitz, John N Pienta, Christina Van Der Feltz-Cornelis and Jess G Fiedorowicz
Journal of psychosomatic research, Vol.140, pp.110290-110290
01/2021
DOI: 10.1016/j.jpsychores.2020.110290
PMID: 33227556
url
https://www.ncbi.nlm.nih.gov/pmc/articles/7945369View
Open Access

Abstract

We sought to determine the frequency of and risk factors for suicide outcomes in somatic symptom and related disorders and whether any risk was independent of co-occurring mental disorders. We conducted a systematic review of studies on suicide death, suicide attempts, and suicidal ideation in those with somatic symptom disorders published prior to September 22, 2020 and indexed in PubMED, MEDLINE, PsycARTICLES, PsycINFO, EMBASE, or SCOPUS according to PRISMA guidelines. Our search yielded 33 articles with significant heterogeneity in study design, sample selection, and assessment for suicide or risk factors. While suicide deaths have not been adequately studied, somatic symptom and related disorders are associated with increased risk for suicidal ideation and suicide attempts, with estimates ranging from 24 to 34% of participants who endorsed current active suicidal ideation and 13–67% of participants who endorsed a prior suicide attempt. The risk appeared independent of co-occurring mental disorders. Identified risk factors for suicide attempts in samples with somatic symptom and related disorders include scores on measures of anger, alexithymia, alcohol use, past hospitalizations, dissociation, and emotional abuse. Although the literature is sparse, there exists evidence for an association, even independent of other mental disorders, between somatic symptom and related disorders and suicide outcomes. Practice guidelines for the management of these disorders should incorporate recommendations for the assessment and management of suicide risk. Future study is necessary to more fully elucidate potential unique risk factors for those suffering from these complex disorders. •Research on suicide deaths in somatic symptom and related disorders is limited.•Current suicidal ideation is more frequent in somatic symptom and related disorders.•Prior suicide attempts are reported in 13–67% of those with somatic symptom disorders.•Co-occurring mental disorders do not fully explain the frequency of suicide outcomes.•Suicide risk assessment is neglected in relevant practice guidelines.
Somatic symptom disorders Suicide attempts Conversion disorder Hypochondriasis Functional disorder Somatoform disorders Suicide Suicidal ideation Illness anxiety disorder

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