Suicidal ideation among adults with arthritis: prevalence and subgroups at highest risk. Data from the 2007-2008 National Health and Nutrition Examination Survey.

OBJECTIVE: To evaluate the prevalence, correlates, and subgroups at highest risk for suicidal ideation among adults with arthritis.
METHODS: We used data on US adults with arthritis, ages ≥40 years, participating in the 2007-2008 National Health and Nutrition Examination Survey. Suicidal ideation was assessed by item 9 of the Patient Health Questionnaire 9 (PHQ-9). Sociodemographic factors, health behaviors, and comorbid conditions were examined as potential correlates. Depression was measured by the PHQ-8 score (range 1-24). We used random forests to identify subgroups at highest risk for suicidal ideation. To determine if any correlates were unique to arthritis, we compared results to those for persons with diabetes mellitus and cancer.
RESULTS: The prevalence ± SEM of suicidal ideation was 5.6% ± 0.8% among persons with arthritis and 2.4% ± 0.4% among those without. The most important correlates for suicidal ideation in adults with arthritis were depression, anxiety, duration of arthritis, age, income:poverty ratio, number of close friends, pain, alcohol, excessive daytime sleepiness, and comorbidities. Eleven of the 16 most important contributors for suicidal ideation among adults with arthritis were also important for people with diabetes mellitus and cancer. Among persons with arthritis, subgroups at highest risk for suicidal ideation were those with a PHQ-8 score between 18 and 24 and less than 4.5 years of arthritis (96.5%), and those with a PHQ-8 score between 7 and 17, ≥1.24 days of binges/month, and either an income of ≥$45,000/year (85.4%) or an income of <$45,000/year and >3 comorbidities (70.8%).
CONCLUSION: Depression, short duration of arthritis, binge drinking, income, and >3 comorbidities identified subgroups of adults with arthritis at greatest risk for suicidal ideation.