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Psychiatry Investig > Volume 20(9); 2023 > Article
Psychiatry Investigation 2023;20(9):834-842.
DOI:    Published online September 19, 2023.
Suicidal Thinking Among Patients With Spinal Conditions in South Korea: A Population-Based Cross-Sectional Study
Tak Kyu Oh1,2  , Hye Yoon Park3  , In-Ae Song1,2 
1Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
2Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
3Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
Correspondence: In-Ae Song ,Tel: +82-31-787-7499, Fax: +82-31-787-4063, Email:
Received: March 2, 2023   Revised: April 15, 2023   Accepted: June 28, 2023   Published online: September 19, 2023
Chronic pain increases the risk of suicide because it is often accompanied by depressive symptoms. However, the existing information regarding suicidal thinking in patients with chronic pain such as spinal conditions is insufficient. We aimed to examine the prevalence of suicidal thinking and the factors associated with it among patients with spinal conditions.
Data from the National Health Insurance Service database in South Korea were used in this population-based, cross-sectional study, and 2.5% of adult patients diagnosed with spinal conditions (low back pain and/or neck pain) between 2018 and 2019 were selected using a stratified random sampling technique. Patient Health Questionnaire–9 was used to determine the presence of suicidal thoughts and depressive symptoms.
33,171 patients with spinal conditions were included in this study. Among them, 5.9% had suicidal thinking and 20.7% had depressive symptoms. In the multivariable logistic regression model, old age, male sex, and employment were associated with a decreased prevalence of suicidal thinking. Current smokers, previous smokers, medical aid program recipients, and patients with mild-to-moderate or severe disability showed increased suicidal thinking. Underlying depression, bipolar disorder, insomnia disorder, and substance abuse were also associated with increased suicidal thinking.
In South Korea, 5.9% and 20.7% of patients with spinal conditions had suicidal thoughts and depressive symptoms, respectively. Some factors were associated with an increased prevalence of suicidal thoughts among patients with spinal conditions. Our results suggest that screening for these factors can help prevent suicide in patients with spinal conditions.
Key words   Suicide; Depressive disorders; Epidemiology


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