Mental defeat predicts increased suicide risk in chronic pain: a 12‐month prospective study

Themelis, K ORCID: https://orcid.org/0000-0002-0022-5272, Gillett, JL, Karadag, P, Cheatle, MD, Ilgen, MA, Balasubramanian, S, Singh, SP and Tang, NKY, 2025. Mental defeat predicts increased suicide risk in chronic pain: a 12‐month prospective study. European Journal of Pain, 29 (2): e4779. ISSN 1090-3801

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Abstract

Background: Mental defeat is considered a potential risk factor for suicidal thoughts and behaviours in chronic pain. This study evaluated the role of mental defeat in predicting future suicide risk and examined whether depression influences this relationship.

Methods: A total of 340 participants with chronic pain completed questionnaires at two time points, 12 months apart. Data collected included sociodemographic and pain characteristics, mental defeat, psychosocial risk factors including depression and health-related variables. Weighted univariate and multivariable analyses assessed the link between mental defeat and suicide risk, with a moderation analysis testing the role of depression.

Results: Higher levels of mental defeat and depression were linked to increased suicide risk at 12 months. Depression significantly amplified the effect of mental defeat on suicide risk, particularly in individuals with higher depression levels (B = 0.06, SE = 0.01, t = 6.21, p < 0.001) compared with moderate (B = 0.05, SE = 0.01, t = 5.20, p < 0.001) or low levels of depression (B = 0.04, SE = 0.01, t = 2.83, p = 0.004), indicating a dose–response relationship.

Conclusions: Mental defeat is a significant risk factor for suicide in chronic pain, with depression intensifying this risk. Addressing both mental defeat and depression simultaneously in treatment may help reduce suicide risk in these patients.

Significance: This study strengthens the evidence linking mental defeat with heightened suicide risk in chronic pain. By providing prospective data, it clarifies the temporality of this relationship. Given that suicide risk doubles in chronic pain patients, whereby comorbid depression is common, these findings have crucial clinical implications. Both mental defeat and depression are modifiable. Addressing them together in treatment may help reduce suicide risk in this population.

Item Type:	Journal article
Publication Title:	European Journal of Pain
Creators:	Themelis, K., Gillett, J.L., Karadag, P., Cheatle, M.D., Ilgen, M.A., Balasubramanian, S., Singh, S.P. and Tang, N.K.Y.
Publisher:	Wiley
Date:	February 2025
Volume:	29
Number:	2
ISSN:	1090-3801
Identifiers:	Number Type 10.1002/ejp.4779 DOI 2382819 Other
Rights:	© 2025 the author(s). European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC ®. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Divisions:	Schools > School of Social Sciences
Record created by:	Jonathan Gallacher
Date Added:	24 Feb 2025 12:35
Last Modified:	24 Feb 2025 12:35
URI:	https://irep.ntu.ac.uk/id/eprint/53125

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