Elsevier

Respiratory Medicine

Volume 151, May 2019, Pages 11-18
Respiratory Medicine

Review article
Chronic obstructive pulmonary disease as a risk factor for suicide: A systematic review and meta-analysis

https://doi.org/10.1016/j.rmed.2019.03.018Get rights and content
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Highlights

  • COPD patients have a higher likelihood of suicide than non-carriers of the disease.

  • Women with COPD have a higher risk of committing suicide than men.

  • There are no studies assessing suicide and COPD in developing countries.

  • Moderate quality of evidence according to GRADE.

Abstract

Background

Patients living with chronic obstructive pulmonary disease (COPD) commonly present several limitations in their daily activities, high depression rates, and low quality of life, which makes this population a risk group for suicide. This study aims to systematically assess the literature on the association between CPOD and the likelihood of suicide.

Methods

The protocol was registered in PROSPERO (CRD42018096618). The Latin-American and Caribbean Health Sciences Literature (LILACS), PubMed, SciELO, Scopus, LIVIVO, Web of Science, and PsychNET databases were used as primary study sources. OpenThesis and OpenGrey were used to partially capture the “grey literature”. A manual search was also performed through a systematized analysis of the references of eligible articles. The risk of bias among the studies included was assessed with the Joanna Briggs Institute Critical Appraisal Tools for Systematic Reviews. A random effects meta-analysis was performed to estimate the variation in odds ratio (OR) and 95% confidence intervals (95% CI).

Results

The search provided 4762 results, from which only seven met the eligibility criteria and were ultimately included in the qualitative assessment of the review. The studies were published from 2002 to 2015. All studies presented low risk of bias. The total sample included 1390 suicide cases of COPD patients. The meta-analysis, which was based on five eligible case control studies, found that people with history of COPD are more likely to commit suicide (OR = 1.90; 95% CI = 1.27–2.48; p = 0.002).

Conclusion

COPD patients are 1.9 times more likely to commit suicide than people without COPD.

Keywords

Chronic obstructive pulmonary disease
Suicide
Risk factors

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