Poster from APOS meeting, Annaheim, California, February 2011

1. P2-28 Predictors of Suicidal Thoughts after Cancer: Which items are
influential in clinically representative ethnically diverse UK sample
Alex J Mitchell Consultant in Psycho-oncology Karen Lord PhD Candidate & CNS Paul Symonds Reader in Oncology
Department of Cancer & Molecular Medicine, University Hospitals Leicester (UK) & University of Leicester ajm80@le.ac.uk
OBJECTIVES
Recently there has been more attention on people with suicidal thoughts who suffer distress or depression in the
context of cancer. However predictors of suicidal thoughts in cancer have not been previously described.
METHODS
We analysed data collected from Leicester Cancer Centre from 2008-2009 involving approximately 1000 people
approached by a research nurse and two therapeutic radiographers. Of those approached we collected data on 738
presentations, that is people seen up to three times over 9 months during treatment for cancer. We had complete data
regarding suicidality on 554 (411 BW 143 BSA). We examined the following factors: treatment intent (radical vs
palliative), gender, ethnicity, cancer type, cancer duration.
We measured suicidal thoughts using the PHQ9, using the question “thoughts that you would be better of dead of hurting
yourself in some way” and scored as follows:
not at all = 0; several days =1; more than half the days = 2; nearly every day = 3.
We report here, the proportion of people with any suicidal thoughts (non zero scores).
RESULTS
Of all patients 510 had no suicidal thoughts, 44 (8%) had some thoughts and 12 had thoughts on “more than half days”. We
found the following predictors of suicidal ideation, examined cross-sectionally in the whole sample:
depression thermometer (p = 0.0002); helplessness hopelessness (p = 0.0021); anxious preoccupation (p < 0.0001), low
fighting spirit (p < 0.0001); HADS-D, PHQ9.
In addition the following problem list concerns were associated with suicidal thoughts: Insurance problems, Transportation
problems, partner problems, bathing dressing problems, eating problems, diarrhoea, urination problems
Mood and Coping Scales
Problem List Items
THERMOMETERS
depression thermometer b4 = 0.39 z = 3.76 Insurance problems b2 = -2.62 z = -2.10 P = 0.035
Transportation problems b4 = -2.19 z = -2.23 P = 0.025
MINI-MAC Partner problems b6 = 1.79 z = 2.18 P = 0.028
helplessness hopelessness b1 = 0.24 z = 3.07 p = 0.0021 Sadness b10 = 2.43 z = 2.62 P = 0.008
anxious preoccupation b2 = 0.50 z = 4.13 p < 0.0001 Depression b11 = 2.65 z = 3.38 P = 0.000
fighting spirit b3 = -1.06 z = -5.35 p < 0.0001 Self-care problems b20 = 2.72 z = 2.695 P = 0.007
Eating problems b23 = 2.06 z = 2.84 P = 0.004
HADS Diarrhoea b26 = 1.59 z = 2.2 P = 0.026
depression total b2 = 0.16 z = 2.92 p = 0.0034 Urination problems b27 = 1.57 z = 2.27 P = 0.022
PHQ9
PHQ9 total b1 = 0.58 z = 5.41 P < 0.0001
CONCLUSIONS
In our clinically representative diverse sample, we found depression and coping style (lack of fighting
spirit) to be the strongest predictor of suicidal ideation. Anxious preoccupation was also predictive.
Several problem list items were also influential.
ACKNOLWEDGEMENT Funding from Hope against Cancer WEBSITE: www.psycho-oncology.info