Self-perception of poor health and suicidal ideation in medical patients

OBJECTIVE: To determine the relationship between self-perceived health and suicidal ideation among patients in general internal medicine practice settings. METHOD: A representative sample of 4007 patients was assessed for current suicidal ideation, self-perception of health, current medical disorders and current mental disorders (major depression, generalized anxiety disorder, panic attacks and alcohol use disorder) with the PRIME-MD Patient Health Questionnaire. RESULTS: Patients with self-perception of poor health, compared with those who reported more favourable health perception, were significantly more likely to report current suicidal ideation (35.2% v. 8.3%; chi2 = 97.4, df = 1, P < 0.0001). Multivariate logistic regression analyses revealed that the perception of poor health was associated with a significantly increased risk of suicidal ideation (OR = 3.1, CI 1.9, 5.0), even after adjusting for sociodemographic characteristics, mental disorders and common physical illnesses. CONCLUSION: Self-perception of poor health is associated with a significantly increased risk of suicidal ideation among general medical patients, even in the absence of common mental and physical disorders. These findings add to a growing literature on the importance of self-perceived health in the treatment and outcomes of mental and physical well-being by documenting self-perceived poor health as a risk factor for suicidal ideation in medical patients.