Suicide risk increases after heart attack
01 December 2010, 16:10
New York - People are more likely to commit suicide in the wake of a heart attack, with the risk rising tripling in the month right after and remaining elevated for at least five years, a study said.
This appears true for both men and women, regardless of socioeconomic status.
The findings come as little surprise, said study author Karen Kjaer Larsen of Aarhus University in Denmark, suggesting that cardiac rehabilitation programmes take this into consideration.
"We know that many patients with myocardial infarction suffer from anxiety and depression," she said. "Our study shows that the mental pain due to MI for some people is so strong that they commit suicide."
The study, which appeared in Circulation, looked at population data from Denmark collected between 1981 and 2006, identifying almost 20 000 people who had committed suicide and comparing them to nearly 200 000 similar people who had not.
They found that more than 4% of people who committed suicide had a history of heart attack, versus less than 3% of the controls.
The risk of suicide was highest the month after patients left the hospital. Risks were also particularly high in patients with a history of psychiatric illness, indicated by a previous admission to a psychiatric hospital, ward or outpatient clinic.
"Before patients with MI are discharged from hospital we need to make sure that they have a safety net and know where to go or who to call if they suddenly feel sad and cannot cope with the situation," Larsen added.
The study did not report on the actual risk of suicide among those who had sustained heart attacks.
Previous research has shown that people are more likely to commit suicide after being diagnosed with other serious conditions, including stroke, epilepsy and diabetes. Other medical professionals agreed with the findings.
"Any sort of major life stressor - and an MI certainly falls in that category - is capable of precipitating a depressive reaction, especially in people who are predisposed, whether by genetics, past exposure to major stressors or both, to develop depression," said Redford Williams at Duke University Medical Centre, who wrote an editorial about the Danish study.
Williams said he supported recommendations of the American Heart Association that all heart attack patients be screened for depression, but warned that it's not yet clear whether treating depression will help the patient's heart or mental state.
He added that study is needed to test whether antidepressants and other interventions help these patients.