Abstract
Aims
This study aims to investigate the association of demographic characteristics, gender, family income, and performance status with suicidal ideation among cancer patients in a LMIC. It also assesses the influence of cancer stage, cancer type, intent of treatment and pain medication on SI in oncology patients.
Methods:
This cross-sectional study enrolled 150 cancer patients in a tertiary care cancer center in Pakistan. Data were collected according to gender, residence, marital status, income brackets, and ECOG status. Validated suicidal ideation questionnaire was used. Variables analyzed also included cancer stage, cancer type, intent of treatment, and use of pain medication including morphine, NSAIDs, and gabapentinoids. Associations were analyzed using chi-square test.
Results:
Among 150 patients, 67.3% had no suicidal ideation (SI), 28.7% weak, and 4% moderate–strong. Males (68.7%) showed higher SI than females (31.3%). SI was significantly associated with ECOG status (p=0.005), employment before diagnosis (p=0.001), and income (p<0.001), particularly ≤$300/month. Cancer type (p<0.001), disease stage showed a non-significant trend (p=0.685) and palliative treatment (p<0.001) showed higher SI. Awareness of diagnosis and prognosis (p=0.001 each), morphine use (p=0.039), and gabapentinoids (p=0.002) were significant. NSAID and benzodiazepine use were not significantly linked.
Conclusion:
Lower income and male gender were associated with increased suicidal ideation in cancer patients. Employment status before diagnosis and decline in performance status showed significant association with SI. Clinical deterioration and inadequate pain management are strongly linked to suicidal ideation in cancer patients. Routine psychological screening and optimal palliative strategies are essential in high-risk groups. These findings also stress the need for psychological support in resource-constrained settings.