Exploring the Incidence of Immediate Suicidality Among Hand Surgery Clinic Patients.
4 affiliations
- 1The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD.
- 2Department of Orthopaedic Surgery, University of Maryland Medical Center, Baltimore, MD.
- 3Department of Orthopaedics, University of Miami, Miami, FL.
- 4MedStar Health Research Institute, Columbia, MD.
Abstract
Purpose
Depression is a known comorbidity in patients with chronic pain and musculoskeletal conditions, including specialty hand clinic patients. A subset experience active suicidal ideation or thoughts of self-harm at or around the time of their visit; however, epidemiological data are limited. We aimed to determine the prevalence of active suicidal ideation and hypothesized that hand surgery patients endorsing it would report greater pain, worse physical function, and greater socioeconomic disadvantage than those without suicidal ideation.Methods
We conducted a retrospective review of patients presenting to our clinic from August 2022 to August 2023. They completed a Patient Health Questionnaire two-question (PHQ-2) screener; those scoring ≥3 completed the PHQ nine-question (PHQ-9). Active suicidal ideation ("high risk") was defined as a nonzero response to item 9 of the PHQ-9. Demographic, socioeconomic (including Area Deprivation Index), and patient-reported outcome data were collected. Chi-squared and t tests were used to compare high- and low-risk patients, and multivariable regression was used to assess adjusted associations between surgical status and follow-up patterns.Results
Of the 7,023 new patients who completed the PHQ-2, 495 (7%) screened positive and completed the PHQ-9; 123 patients (1.8% of total) endorsed active suicidal ideation. Compared with low-risk patients, high-risk patients reported significantly higher pain, poorer global physical health, and worse upper extremity function, along with greater socioeconomic disadvantages, including higher Area Deprivation Index scores and more frequent transportation barriers. No significant differences occurred in surgical rates or follow-up utilization between high- and low-risk patients, including after stratification by procedure type.Conclusions
Approximately 1 in 50 new patients reported active suicidality, greater pain, worse physical function, and greater socioeconomic burden-differences that exceeded published minimal clinically important differences. Screening tools and targeted surgeon education may aid in early identification and guide opportunities for intervention and support.Type of study/level of evidence
Prognostic IV.
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BibTeX
@article{hum2026exploring,
title = {{Exploring the Incidence of Immediate Suicidality Among Hand Surgery Clinic Patients.}},
author = {Richard Hum and Roland Zama and Yanbao Xiong and Gabriel J Yohe and Aviram M Giladi},
journal = {Journal of hand surgery global online},
year = {2026},
month = oct,
doi = {10.1016/j.jhsg.2026.101162},
url = {https://europepmc.org/article/MED/42898229},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Exploring the Incidence of Immediate Suicidality Among Hand Surgery Clinic Patients.
AU - Richard Hum
AU - Roland Zama
AU - Yanbao Xiong
AU - Gabriel J Yohe
AU - Aviram M Giladi
PY - 2026
DA - 2026/10/09
JO - Journal of hand surgery global online
DO - 10.1016/j.jhsg.2026.101162
UR - https://europepmc.org/article/MED/42898229
AB - Purpose Depression is a known comorbidity in patients with chronic pain and musculoskeletal conditions, including specialty hand clinic patients. A subset experience active suicidal ideation or thoughts of self-harm at or around the time of their visit; however, epidemiological data are limited. We aimed to determine the prevalence of active suicidal ideation and hypothesized that hand surgery patients endorsing it would report greater pain, worse physical function, and greater socioeconomic disadvantage than those without suicidal ideation.Methods We conducted a retrospective review of patients presenting to our clinic from August 2022 to August 2023. They completed a Patient Health Questionnaire two-question (PHQ-2) screener; those scoring ≥3 completed the PHQ nine-question (PHQ-9). Active suicidal ideation ("high risk") was defined as a nonzero response to item 9 of the PHQ-9. Demographic, socioeconomic (including Area Deprivation Index), and patient-reported outcome data were collected. Chi-squared and t tests were used to compare high- and low-risk patients, and multivariable regression was used to assess adjusted associations between surgical status and follow-up patterns.Results Of the 7,023 new patients who completed the PHQ-2, 495 (7%) screened positive and completed the PHQ-9; 123 patients (1.8% of total) endorsed active suicidal ideation. Compared with low-risk patients, high-risk patients reported significantly higher pain, poorer global physical health, and worse upper extremity function, along with greater socioeconomic disadvantages, including higher Area Deprivation Index scores and more frequent transportation barriers. No significant differences occurred in surgical rates or follow-up utilization between high- and low-risk patients, including after stratification by procedure type.Conclusions Approximately 1 in 50 new patients reported active suicidality, greater pain, worse physical function, and greater socioeconomic burden-differences that exceeded published minimal clinically important differences. Screening tools and targeted surgeon education may aid in early identification and guide opportunities for intervention and support.Type of study/level of evidence Prognostic IV.
SN - 2589-5141
ER -