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dc.contributor.authorHultcrantz, Malin
dc.contributor.authorSvensson, Tobias
dc.contributor.authorDerolf, Åsa R
dc.contributor.authorKristinsson, Sigurdur Y
dc.contributor.authorLindqvist, Ebba K
dc.contributor.authorEkbom, Anders
dc.contributor.authorGranath, Fredrik
dc.contributor.authorBjörkholm, Magnus
dc.date.accessioned2015-08-18T15:12:51Zen
dc.date.available2015-08-18T15:12:51Zen
dc.date.issued2015-01en
dc.date.submitted2015en
dc.identifier.citationCancer Med. 2015, 4 (1):147-54en
dc.identifier.issn2045-7634en
dc.identifier.pmid25155101en
dc.identifier.doi10.1002/cam4.316en
dc.identifier.urihttp://hdl.handle.net/2336/575148en
dc.descriptionTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.en
dc.description.abstractSolid tumors are associated with an increased risk of suicide, however, there is limited detailed information on the risk of suicide in patients with hematological malignancies. Therefore, we conducted a population-based study including 47,220 patients with hematological malignancies (diagnosed 1992-2006) and their 235,868 matched controls to define the incidence and risk factors for suicide and suicide attempt. Information on suicides, suicide attempts, and preexisting psychiatric disorders was obtained from Swedish registers and individual medical records. There was a twofold increased (hazard ratio [HR] = 1.9, 95% confidence interval 1.5-2.3, P < 0.0001) risk of suicide/suicide attempt during the first 3 years after diagnosis in patients with hematological malignancies compared to matched controls. Of all hematological malignancies, multiple myeloma was associated with the highest risk (HR = 3.4; 2.3-5.0, P < 0.0001). Patients with a preexisting psychiatric disorder were at a very high risk of suicide and suicide attempt (HR = 23.3; 16.6-32.6, P < 0.0001), regardless of type of hematological malignancy. Among patients who committed suicide, 19% were in a palliative phase and 44% were in remission with no active treatment. In conclusion, the risk of suicide and suicide attempt is elevated in patients with hematological malignancies. Certain high-risk patients may benefit from early detection and preventive measures.
dc.description.sponsorshipSwedish Cancer Society CAN 2012/483 regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet 20120004 Adolf H Lundin Charitable Foundation Blodcancerfondenen
dc.language.isoenen
dc.publisherWiley-Blackwellen
dc.relation.urlhttp://dx.doi.org/ 10.1002/cam4.316en
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4312128/en
dc.rightsArchived with thanks to Cancer medicineen
dc.subjectKrabbameinen
dc.subjectSjálfsvígen
dc.subjectGeðsjúkdómaren
dc.subject.meshRetrospective Studiesen
dc.subject.meshRisk Factorsen
dc.subject.meshSuicide, Attempted/statistics & numerical data*en
dc.subject.meshIceland/epidemiology Young Aduen
dc.subject.meshHematologic Neoplasmsen
dc.subject.meshMultiple Myelomaen
dc.subject.meshMental Disordersen
dc.subject.meshSuicideen
dc.titleIncidence and risk factors for suicide and attempted suicide following a diagnosis of hematological malignancy.en
dc.typeArticleen
dc.contributor.department[ 1 ] Karolinska Univ Hosp Solna, Div Hematol, Dept Med, SE-17176 Stockholm, Sweden [ 2 ] Karolinska Inst, Stockholm, Sweden [ 3 ] Karolinska Univ Hosp Solna, Clin Epidemiol Unit, Dept Med, SE-17176 Stockholm, Sweden [ 4 ] Univ Iceland, Fac Med, Reykjavik, Iceland [ 5 ] Landspitali Natl Univ Hosp, Dept Hematol, Reykjavik, Icelanden
dc.identifier.journalCancer medicineen
dc.rights.accessOpen Accessen
html.description.abstractSolid tumors are associated with an increased risk of suicide, however, there is limited detailed information on the risk of suicide in patients with hematological malignancies. Therefore, we conducted a population-based study including 47,220 patients with hematological malignancies (diagnosed 1992-2006) and their 235,868 matched controls to define the incidence and risk factors for suicide and suicide attempt. Information on suicides, suicide attempts, and preexisting psychiatric disorders was obtained from Swedish registers and individual medical records. There was a twofold increased (hazard ratio [HR] = 1.9, 95% confidence interval 1.5-2.3, P < 0.0001) risk of suicide/suicide attempt during the first 3 years after diagnosis in patients with hematological malignancies compared to matched controls. Of all hematological malignancies, multiple myeloma was associated with the highest risk (HR = 3.4; 2.3-5.0, P < 0.0001). Patients with a preexisting psychiatric disorder were at a very high risk of suicide and suicide attempt (HR = 23.3; 16.6-32.6, P < 0.0001), regardless of type of hematological malignancy. Among patients who committed suicide, 19% were in a palliative phase and 44% were in remission with no active treatment. In conclusion, the risk of suicide and suicide attempt is elevated in patients with hematological malignancies. Certain high-risk patients may benefit from early detection and preventive measures.


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