Available meta-analytic evidence suggests an increased risk of suicide among cancer patients, although most of the reports focused on the sole suicide death (SD) outcome and they are usually hampered by significant between-study heterogeneity.

The present meta-analysis aimed at assessing the prevalence and risk rates of SD, suicide attempt (SA), and suicidal ideation (SI) among cancer patients.

Systematic search up to April 2021 of observational studies documenting cancer and suicide outcomes associations. Pooled prevalence estimates, odd ratios (ORs), risk ratios (RRs), and hazard ratios (HRs) of SD, SA, and SI were computed according to the random-effects model. SD prevalence underwent cumulative and sub-group analyses for different variables. Risk estimates underwent sensitivity analysis for study design.

Overall, thirty-nine studies were included. A higher risk of SD based on HR, SA based on OR and HR, and SI based on each measure was recorded among cancer patients versus controls. OR and RR of SD were not significant. Pooled prevalence rates of SD, SA and SI among cancer patients were 1.9% (1.1-3.1%), 1.4% (0.3-7.1%), and 9.1% (5.8-14.0%), respectively. Although high between-study heterogeneity held upon sensitivity and sub-group analyses, the overall message brought by risk analyses likewise held true. Age, country, study design, cancer type, sample size, cases type and comparison affected SD prevalence estimates in cancer patients. SD prevalence decreased over time.

Cancer patients face higher risk for SA and SI versus controls. SD’ results were controversial. Cancer patients have higher prevalence rates of suicide outcomes compared to the general population.

No significant relationships.

Acute and transient psychotic disorders (ATPDs) are a group of diagnoses with acute onset and polymorphic psychotic symptoms, divided into 6 subtypes, which may or may not associate with acute stress. Suicide is a serious public health problem, having long-lasting effects on social well-being and economics. The prevalence of suicide attempts (SA) in Latvia remains unknown, several studies are currently in progress.

To determine the prevalence of SA among patients with ATPDs and features of this subgroup of patients.

Retrospective study based on socio-demographic data and additional diagnoses of all patients with ATPDs provided by the National Center of Statistics of Diseases.

There were 1779 patients with ATDPs in 2014-2019, 44 people were admitted with a SA (24 men, 54.5%). There was a significant difference between sexes in the mean age – 39.64±14.66 for women, 31.94±11.88 for men (p<.001), as well as in case of associated acute stress – 37.61±12.95 with and 35.33±13.15 without it (p=.01). There were no differences in age or ATPDs subtypes between patients with SA and without one. Men with SA abused alcohol in everyday life more than women and men without SA (20%,p<.001), women with SA had acculturational difficulties more often than men and women without SA (45%,p<.001). Intentional self-harm by sharp objects was more common among men (p<.001), intentional self-poisoning among women (p<.001).

The prevalence of SA among patients with ATPDs was 2.47%. Factors, which were more commonly observed in patients with SA were alcohol consumption and acculturational difficulties. Types of self-harming differ between sexes.

No significant relationships.

Sleep disorders and psychiatric disease are closely related, and psychiatric diseases are associated with elevated suicide risks. Yet, the association between sleep disorders and suicide remains to be assessed using a consistent measure of sleep disorders.

The aim of this study was to examine whether people with a hospital-diagnosis of sleep disorders had higher suicide rates than people with no diagnosis.

In a cohort study, nationwide data on all persons aged 15+ years living in Denmark during 1980-2016 were analysed. Sleep disorders were identified through diagnoses recorded during contacts to somatic hospitals. Incidence Rate Ratios (IRR) were estimated using Poisson regression models and adjusted for relevant covariates.

In all, 3,674,563 males and 3,688,164 females were included, of whom 82,223 (2.2%, mean age: 50.2, SD: 17.5) males and 40,003 (1.1%, mean age: 50.6, SD: 19.9) females had sleep disorder diagnoses. Compared to those with no sleep disorders, the adjusted IRRs for suicide were 1.6 (95% CI, 1.4-1.7) and 2.2 (95% CI, 1.8-2.6) for males and females with sleep disorders, respectively. Excess rates for narcolepsy were found for males (IRR:1.2, 95% CI, 1.0-1.5) and females (IRR:3.3, 95% CI, 3.0-4.1), and for sleep apnea in males (IRR:1.8, 95% CI, 1.5-2.2). Males and females had IRRs of 4.1 (95% CI, 3.1-5.5) and 7.0 (95% CI, 4.8-10.1), respectively, 6 months after being diagnosed with a sleep disorder.

Sleep disorders were associated with higher suicide rates even after adjusting for pre-existing mental disorders. Our findings suggest attention towards suicidal ideation in patients suffering from sleep disorders is warranted.

Disclosures and Acknowledgements: Adam Spira has received honoraria for serving as a consultant to Merck and from Springer Nature Switzerland AG for guest editing special issues of Current Sleep Medicine Reports. The other authors report no conflict of in