{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:15:33Z","timestamp":1790054133646,"version":"4.0.1"},"reference-count":35,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: One of the most relevant risk factors for suicide is the terminal stage of oncological disease. However, it remains unclear whether palliative care affects suicide rates in this population. This study aimed to compare suicide rates in oncological patients receiving palliative care to a general oncological cohort. Methods: The rate of suicide among all patients admitted to the palliative care ward at the Medical University of Vienna for oncological diagnoses from November 2012 to March 2022 was compared to that of a diagnosis-matched control group retrieved from the Austrian Cancer Registry. Competing risk models in SAS (SAS Institute Inc., Cary, NC, USA) were used to test for significant differences in cumulative incidences of death by suicide. Cumulative incidences were also compared for sex and the most common diagnostic groups separately. Results: 1524 patients with oncological diagnoses receiving palliative care and 794,986 patients in the control group were included in the analysis. No excess suicide mortality was revealed (p = 0.117) in the group of patients receiving palliative care. Importantly, this remained true, after also including any potential cases of suicide within the palliative care sample in the analysis (p = 0.467). Only for patients with pancreatic cancer, a higher cumulative suicide incidence in the palliative care sample was found (p = 0.008). Conclusions: Palliative care for oncological patients may be able to alleviate the excess suicide mortality that is otherwise expected in terminally ill patients. This study underscores the importance of comprehensive multidisciplinary end-of-life care that addresses not only physical but also psychosocial aspects.<\/jats:p>","DOI":"10.3390\/jcm15062149","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T15:32:09Z","timestamp":1773243129000},"page":"2149","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Suicide Rates Among Patients Receiving Palliative Care\u2014Descriptive Results of a National Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0466-0420","authenticated-orcid":false,"given":"Stephan","family":"Listabarth","sequence":"first","affiliation":[{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Sommer","sequence":"additional","affiliation":[{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Trojer","sequence":"additional","affiliation":[{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Weber","sequence":"additional","affiliation":[{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Gr\u00f6mer","sequence":"additional","affiliation":[{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2043-8299","authenticated-orcid":false,"given":"Thomas","family":"Waldhoer","sequence":"additional","affiliation":[{"name":"Center for Public Health, Department of Epidemiology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Hackl","sequence":"additional","affiliation":[{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Therapiezentrum Ybbs, Wiener Gesundheitsverbund, 3370 Ybbs an der Donau, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Vyssoki","sequence":"additional","affiliation":[{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Psychosocial Health Center ESRA, 1020 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6415-4488","authenticated-orcid":false,"given":"Eva Katharina","family":"Masel","sequence":"additional","affiliation":[{"name":"Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1699-9846","authenticated-orcid":false,"given":"Matthias","family":"Unseld","sequence":"additional","affiliation":[{"name":"Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Department of Clinical Research SBG, Academy for Ageing Research, Haus der Barmherzigkeit, 1160 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5741-834X","authenticated-orcid":false,"given":"Daniel","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2019). Suicide in the World. Global Health Estimates, Oxford University Press."},{"key":"ref_2","unstructured":"Prammer-Waldh\u00f6r, M., and Ihle, P. (2025). Statistik Austria Jahrbuch der Gesundheitsstatistik 2023, Statistik Austria."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1016\/S0140-6736(15)00234-2","article-title":"Suicide and Suicidal Behaviour","volume":"387","author":"Turecki","year":"2016","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/00005792-199411000-00001","article-title":"Suicide as an Outcome for Medical Disorders","volume":"73","author":"Barraclough","year":"1994","journal-title":"Medicine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.genhosppsych.2014.05.017","article-title":"Increased Suicide Risk in Cancer Patients in Tyrol\/Austria","volume":"36","author":"Oberaigner","year":"2014","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4731","DOI":"10.1200\/JCO.2007.13.8941","article-title":"Incidence of Suicide in Persons With Cancer","volume":"26","author":"Misono","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1038\/s41591-022-01745-y","article-title":"Suicide Risk and Mortality among Patients with Cancer","volume":"28","author":"Heinrich","year":"2022","journal-title":"Nat. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.jad.2015.01.028","article-title":"Suicide among 915,303 Austrian Cancer Patients: Who Is at Risk?","volume":"175","author":"Vyssoki","year":"2015","journal-title":"J. Affect. Disord."},{"key":"ref_9","first-page":"100562","article-title":"Risk of Suicide after Diagnosis of Severe Physical Health Conditions: A Retrospective Cohort Study of 47 Million People","volume":"25","author":"Nafilyan","year":"2022","journal-title":"Lancet Reg. Health\u2014Eur."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e70030","DOI":"10.1002\/pon.70030","article-title":"Perceived Control as a Potential Protective Factor for Suicidal Thoughts and Behaviors in Cancer Patients and Survivors: A Systematic Review With Meta-Analysis","volume":"33","author":"Hirschmiller","year":"2024","journal-title":"Psycho Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1080\/16506070510008461","article-title":"A Burden to Others: A Common Source of Distress for the Terminally Ill","volume":"34","author":"Wilson","year":"2005","journal-title":"Cogn. Behav. Ther."},{"key":"ref_12","first-page":"8417","article-title":"Systematic Review on Factors Associated with Self-Perceived Burden among Cancer Patients","volume":"30","author":"Liu","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"637","DOI":"10.5964\/ejop.v15i3.1741","article-title":"Interventions for Reducing Suicide Risk in Cancer Patients: A Literature Review","volume":"15","author":"Bulotiene","year":"2019","journal-title":"Eur. J. Psychol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1080\/13548506.2015.1058960","article-title":"Suicide Ideation among Oncologic Patients in a Spanish Ward","volume":"21","year":"2016","journal-title":"Psychol. Health Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1001\/jama.1983.03330300035030","article-title":"The Prevalence of Psychiatric Disorders Among Cancer Patients","volume":"249","author":"Derogatis","year":"1983","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2907","DOI":"10.1001\/jama.284.22.2907","article-title":"Depression, Hopelessness, and Desire for Hastened Death in Terminally Ill Patients With Cancer","volume":"284","author":"Breitbart","year":"2000","journal-title":"JAMA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1191\/0269216303pm670oa","article-title":"Psychiatric Disorder in a Palliative Care Unit","volume":"17","author":"Durkin","year":"2003","journal-title":"Palliat. Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Sch\u00f6nenberg, A., Zipprich, H.M., Teschner, U., and Prell, T. (2022). Impact of Depression, Resilience, and Locus of Control on Adjustment of Health-Related Expectations in Aging Individuals With Chronic Illness. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.867785"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1513\/AnnalsATS.201805-299RL","article-title":"Incidence of Suicide and Association with Palliative Care among Patients with Advanced Lung Cancer","volume":"15","author":"Sullivan","year":"2018","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e63","DOI":"10.1016\/j.jpainsymman.2022.04.179","article-title":"Palliative Care and Documented Suicide: Association Among Veterans With High Mortality Risk","volume":"64","author":"Khazanov","year":"2022","journal-title":"J. Pain Symptom Manag."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1001\/jamaoto.2021.2625","article-title":"Risk of Suicidal Self-Directed Violence Among US Veteran Survivors of Head and Neck Cancer","volume":"147","author":"Nugent","year":"2021","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1016\/S0140-6736(99)02232-1","article-title":"Suicide among Patients with Cancer Cared for at Home by Palliative-Care Teams","volume":"354","author":"Ripamonti","year":"1999","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1177\/026921639701100408","article-title":"The Incidence of Suicide in Palliative Care Patients","volume":"11","author":"Grzybowska","year":"1997","journal-title":"Palliat. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1002\/pon.1839","article-title":"The Wish to Hasten Death: A Review of Clinical Studies","volume":"20","author":"Balaguer","year":"2011","journal-title":"Psycho Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.jpainsymman.2019.11.009","article-title":"Mapping Levels of Palliative Care Development in 198 Countries: The Situation in 2017","volume":"59","author":"Clark","year":"2020","journal-title":"J. Pain Symptom Manage."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-C\u00e1rdenas, M.A., Garralda, E., Ben\u00edtez, E., Arias-Casais, N., van Steijn, D., and Centeno, C. (2021). Palliative Care Coverage across European National Health Systems: Proposal of a Synthetic Indicator. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182010753"},{"key":"ref_27","unstructured":"Pelttari, L., Pissarek, A.H., Nemeth, C., and Slezak, N. (2021). Hospiz-und Palliative Care in \u00d6sterreich 2020: Datenbericht der Spezialisierten Hospiz-und Palliativeinrichtungen, der Bildungsarbeit Sowie der Projekte in der Grundvesorgung, Dachverband Hospiz \u00d6sterreich."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1001\/jama.2016.16840","article-title":"Association Between Palliative Care and Patient and Caregiver Outcomes: A Systematic Review and Meta-Analysis","volume":"316","author":"Kavalieratos","year":"2016","journal-title":"JAMA"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1093\/annonc\/mdl385","article-title":"Suicide and Cancer: A Gender-Comparative Study","volume":"18","author":"Kendal","year":"2007","journal-title":"Ann. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1027\/0227-5910\/a000149","article-title":"Comparative Risk Factors for Accidental and Suicidal Death in Cancer Patients","volume":"33","author":"Kendal","year":"2012","journal-title":"Crisis"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3987","DOI":"10.31557\/APJCP.2024.25.11.3987","article-title":"Sex-Specific Factors Associated with Suicidal Ideation among Patients with Cancer in Korea: A Population-Based Study","volume":"25","author":"Park","year":"2024","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e020992","DOI":"10.1136\/bmjopen-2017-020992","article-title":"Increase in Assisted Suicide in Switzerland: Did the Socioeconomic Predictors Change? Results from the Swiss National Cohort","volume":"8","author":"Steck","year":"2018","journal-title":"BMJ Open"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e256841","DOI":"10.1001\/jamanetworkopen.2025.6841","article-title":"Incidence and Prevalence of Reported Euthanasia Cases in Belgium, 2002 to 2023","volume":"8","author":"Wels","year":"2025","journal-title":"JAMA Netw. Open"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1001\/archgenpsychiatry.2011.66","article-title":"Declining Autopsy Rates and Suicide Misclassification: A Cross-National Analysis of 35 Countries","volume":"68","author":"Kapusta","year":"2011","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Sleeman, K.E., Timms, A., Gillam, J., Anderson, J.E., Harding, R., Sampson, E.L., and Evans, C.J. (2021). Priorities and Opportunities for Palliative and End of Life Care in United Kingdom Health Policies: A National Documentary Analysis. BMC Palliat. Care, 20.","DOI":"10.1186\/s12904-021-00802-6"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2149\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T15:37:36Z","timestamp":1773243456000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":35,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15062149"],"URL":"https:\/\/doi.org\/10.3390\/jcm15062149","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]}}}