{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T13:14:59Z","timestamp":1772889299176,"version":"3.50.1"},"reference-count":51,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Women diagnosed with breast cancer experience severe trauma. Psychological help for breast cancer patients is not sufficient because of limited professional resources. The goal of this study was to identify groups of breast cancer patients with the greatest suicidal risk, who could be the first target for psychosocial interventions. Materials and Methods: The study included 421 women with stage T1\u2013T3\/N0\u2013N3\/M0 breast cancer. We provided women with a set of questionnaires 1\u20132 days prior to breast surgery and one year after surgery. One hundred eighty-eight patients completed the questionnaires after one year. We used the Beck Depression Inventory Second Edition (BDI-II) item Suicidal Thoughts or Intentions for the assessment of suicidal risk. The Impact of Event Scale-Revised (IES-R) was used to measure the risk of PTSD and the Vrana\u2013Lauterbach Traumatic Events Questionnaire-Civilian, TEQ-C (TEQ-CV) was used to measure whether patients had experienced other traumatic events in their lifetime. Results: The incidence of suicidal ideation one year after surgery increased from 4.3% to 12.8% of patients. Patients who lived in rural areas had a two times greater risk of suicidal thoughts than patients who lived in urban areas. Working patients were 2.5 times more likely to have suicidal thoughts prior to surgery. Severely traumatic events increased the chances of suicidal ideation (OR 7.72; 95% CI 1.63\u201336.6; p = 0.01). The symptoms of PTSD showed a threefold increase in the likelihood of suicidal ideation (OR 2.89; 95% CI 0.98\u20138.55; p = 0.05). Conclusions: Living in the countryside, having a history of traumatic experience, having a paid job and having symptoms of post-traumatic stress disorder influence suicidal ideation in breast cancer patients. Particular attention should be drawn to individuals with multiple risk factors.<\/jats:p>","DOI":"10.3390\/medicina58070863","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T01:48:38Z","timestamp":1656467318000},"page":"863","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Factors Affecting Suicidal Thoughts in Breast Cancer Patients"],"prefix":"10.3390","volume":"58","author":[{"given":"Jurgita","family":"Kazlauskiene","sequence":"first","affiliation":[{"name":"Faculty of Health Care, Vilnius University of Applied Sciences, Saltoniskiu Str. 58, LT-08105 Vilnius, Lithuania"},{"name":"Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio Str. 21\/27, LT-03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvydas","family":"Navickas","sequence":"additional","affiliation":[{"name":"Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio Str. 21\/27, LT-03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigita","family":"Lesinskiene","sequence":"additional","affiliation":[{"name":"Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio Str. 21\/27, LT-03101 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4536-6669","authenticated-orcid":false,"given":"Giedre","family":"Bulotiene","sequence":"additional","affiliation":[{"name":"Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio Str. 21\/27, LT-03101 Vilnius, Lithuania"},{"name":"Department of Physical Medicine and Rehabilitation, National Cancer Institute, Santariskiu Str. 1, LT-08660 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021, December 11). Breast Cancer: Prevention and Control. Available online: http:\/\/www.who.int\/cancer\/detection\/breastcancer\/en\/index1.html."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"150","DOI":"10.6001\/actamedica.v22i3.3198","article-title":"Kr\u016bties v\u0117\u017eys Lietuvoje","volume":"22","author":"Lachej","year":"2015","journal-title":"Acta Medica Litu"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Ng, C.G., Mohamed, S., Kaur, K., Sulaiman, A.H., Zainal, N.Z., and Taib, N.A. (2017). Perceived distress and its association with depression and anxiety in breast cancer patients. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0172975"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ctrv.2019.01.003","article-title":"eHealth for improving quality of life in breast cancer patients: A systematic review","volume":"74","author":"Triberti","year":"2019","journal-title":"Cancer Treat. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"871","DOI":"10.12740\/PP\/OnlineFirst\/63787","article-title":"Evaluation of quality of life in women with breast cancer, with particular emphasis on sexual satisfaction, future perspectives and body image, depending on the method of surgery","volume":"51","author":"Slowik","year":"2017","journal-title":"Psychiatr. Polska"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s10549-009-0550-7","article-title":"Changes in the Body Image and Relationship Scale following a one-year strength training trial for breast cancer survivors with or at risk for lymphedema","volume":"121","author":"Speck","year":"2010","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.17219\/acem\/103626","article-title":"Negative body image in breast cancer patients","volume":"28","year":"2019","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref_8","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_9","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1037\/bul0000084","article-title":"Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research","volume":"143","author":"Franklin","year":"2017","journal-title":"Psychol. Bull."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1017\/S0033291714001639","article-title":"Risk of suicide and suicide attempts associated with physical disorders: A population-based, balancing score-matched analysis","volume":"45","author":"Bolton","year":"2015","journal-title":"Psychol Med."},{"key":"ref_11","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_12","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1016\/j.canep.2013.05.009","article-title":"Suicides among cancer patients in Lithuania: A population-based census-linked study","volume":"37","author":"Smailyte","year":"2013","journal-title":"Cancer Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2848","DOI":"10.1002\/pon.3367","article-title":"Determinants of suicidal ideation in patients with breast cancer","volume":"22","author":"Kim","year":"2013","journal-title":"Psychooncology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.cpr.2017.09.009","article-title":"Examining the role of sex in self-injurious thoughts and behaviors","volume":"66","author":"Fox","year":"2018","journal-title":"Clin. Psychol. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.comppsych.2018.08.003","article-title":"Nonsuicidal self-injury, suicide ideation and suicide attempts in the National Guard","volume":"86","author":"May","year":"2018","journal-title":"Compr. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4725","DOI":"10.1200\/JCO.2007.11.8844","article-title":"Better off dead: Suicidal thoughts in cancer patients","volume":"26","author":"Walker","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1002\/pon.4017","article-title":"Managing suicidal ideation in a breast cancer cohort seeking reconstructive surgery","volume":"25","author":"Ballard","year":"2016","journal-title":"Psychooncology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1002\/pon.3705","article-title":"Suicide in cancer patients within the first year of diagnosis","volume":"24","author":"Ahn","year":"2015","journal-title":"Psychooncology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4209","DOI":"10.1200\/JCO.2004.02.052","article-title":"Suicide Risk in Cancer Patients from 1960 to 1999","volume":"22","author":"Hem","year":"2004","journal-title":"J. Clin. Oncol."},{"key":"ref_20","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_21","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1002\/pon.4570","article-title":"Trends in incidence and associated risk factors of suicide mortality among breast cancer patients","volume":"27","author":"Gaitanidis","year":"2018","journal-title":"Psychooncology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/pon.3409","article-title":"Prevalence of depression in cancer patients: A meta-analysis of diagnostic interviews and self-report instruments","volume":"23","author":"Krebber","year":"2014","journal-title":"Psychooncology"},{"key":"ref_23","first-page":"4831","article-title":"Factors Associated with Suicide Risk in Advanced Cancer Patients: A Cross-Sectional Study","volume":"17","author":"Park","year":"2016","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_24","first-page":"74","article-title":"Selected problems of the relation between pain-immunity and depression","volume":"5","author":"Ortenburger","year":"2017","journal-title":"Phys. Act. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jad.2013.01.004","article-title":"Risk factors for suicide in individuals with depression: A systematic review","volume":"147","author":"Hawton","year":"2013","journal-title":"J. Affect. Disord."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1038\/mp.2009.29","article-title":"Mental disorders, comorbidity and suicidal behavior: Results from the National Comorbidity Survey Replication","volume":"15","author":"Nock","year":"2010","journal-title":"Mol. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/j.ejca.2003.12.022","article-title":"Suicide mortality is decreasing among cancer patients in Central Italy","volume":"40","author":"Miccinesi","year":"2004","journal-title":"Eur. J. Cancer"},{"key":"ref_28","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_29","doi-asserted-by":"crossref","unstructured":"Bulotiene, G., Veseliunas, J., and Ostapenko, V. (2007). Quality of life of Lithuanian women with early stage breast cancer. BMC Public Health, 7, Available online: https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17594500.","DOI":"10.1186\/1471-2458-7-124"},{"key":"ref_30","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_31","unstructured":"World Health Organization (2021, November 04). Suicide Mortality Rates. Available online: http:\/\/apps.who.int\/gho\/data\/node.sdg.3\u20134-viz-2?lang=en."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Beck, A.T., Steer, R.A., and Brown, G.K. (1996). Beck Depression Inventory: Second Edition Manual, The Psychological Corporation.","DOI":"10.1037\/t00742-000"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.4088\/JCP.14m09391","article-title":"The Predictive Validity of the Beck Depression Inventory Suicide Item","volume":"76","author":"Green","year":"2015","journal-title":"J. Clin. Psychiatry"},{"key":"ref_34","unstructured":"Wilson, J.P., and Keane, T.M. (1997). The impact of event scale\u2013revised. Assessing Psychological Trauma and PTSD, New York Guilford Press."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"22","DOI":"10.15388\/Psichol.2006..4319","article-title":"\u012evykio poveikio skal\u0117s\u2014Revizuotos (IES-R) lietuvi\u0161kos versijos psichometrin\u0117s savyb\u0117s","volume":"2006","author":"Kazlauskas","year":"2006","journal-title":"Psichologija"},{"key":"ref_36","first-page":"185","article-title":"The Impact of Event Scale\u2014Revised: Psychometric properties of the Lithuanian version in a sample of employees exposed to workplace bullying","volume":"23","year":"2016","journal-title":"Acta Med. Litu."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.brat.2003.07.010","article-title":"Psychometric properties of the Impact of Event Scale\u2014Revised","volume":"41","author":"Creamer","year":"2003","journal-title":"Behav. Res. Ther."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"118","DOI":"10.3389\/fpsyg.2015.00118","article-title":"Dissociative symptomatology in cancer patients","volume":"6","author":"Civilotti","year":"2015","journal-title":"Front. Psychol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1023\/A:1007831430706","article-title":"The Relationship among Personality Variables, Exposure to Traumatic Events, and Severity of Posttraumatic Stress Symptoms","volume":"14","author":"Lauterbach","year":"2001","journal-title":"J. Trauma. Stress"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1176\/appi.psy.42.2.133","article-title":"Psychophysiologic assessment of posttraumatic stress disorder in breast cancer patients","volume":"42","author":"Pitman","year":"2001","journal-title":"Psychosomatics"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"122","DOI":"10.15388\/SocMintVei.2005.1.5989","article-title":"Tarpusavio santyki\u0173 kokyb\u0117 Lietuvos \u0161eimose","volume":"15","year":"2005","journal-title":"Sociol Mintis Ir Veiksmas"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1080\/14034940410019226","article-title":"Are cancer patients at higher suicide risk than the general population? A nationwide register study in Sweden from 1965 to 1999","volume":"33","author":"Edberg","year":"2005","journal-title":"Scand. J. Public Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1080\/13811118.2013.722056","article-title":"Suicide in Cancer Patients in California, 1997\u20132006","volume":"16","author":"Nasseri","year":"2012","journal-title":"Arch. Suicide Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"140","DOI":"10.5694\/j.1326-5377.2008.tb01555.x","article-title":"Risk of Suicide in Cancer Patients in Western Australia, 1981\u20132002","volume":"188","author":"Dormer","year":"2008","journal-title":"Med. J. Aust."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1002\/cncr.31876","article-title":"Suicidal death within a year of a cancer diagnosis: A population-based study","volume":"125","author":"Saad","year":"2019","journal-title":"Cancer"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1038\/sj.bjc.6602424","article-title":"Suicides among Danish cancer patients 1971\u20131999","volume":"92","author":"Yousaf","year":"2005","journal-title":"Br. J. Cancer"},{"key":"ref_47","first-page":"1661","article-title":"Assessment of Depression and Anxiety in Breast Cancer Patients: Prevalence and Associated Factors","volume":"19","author":"Tsaras","year":"2018","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"31","DOI":"10.5200\/sm-hs.2014.005","article-title":"Savi\u017eudi\u0161kam elgesiui \u012ftakos turintys veiksniai: Socialin\u0117s-demografin\u0117s charakteristikos bei psichikos sutrikimai","volume":"24","author":"Juodakys","year":"2014","journal-title":"Sveik. Moksl."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1111\/j.1524-4741.2009.00812.x","article-title":"Coping with a Diagnosis of Breast Cancer-Literature Review and Implications for Developing Countries","volume":"15","year":"2009","journal-title":"Breast J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.pec.2016.11.008","article-title":"Breaking bad news to patients with cancer: A randomized control trial of a brief communication skills training module incorporating the stories and preferences of actual patients","volume":"100","author":"Gorniewicz","year":"2017","journal-title":"Patient Educ. Couns."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.ejon.2005.10.007","article-title":"Information needs and experiences: An audit of UK cancer patients","volume":"10","author":"Cox","year":"2006","journal-title":"Eur. J. Oncol. Nurs."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/7\/863\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:39:51Z","timestamp":1760139591000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/7\/863"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,28]]},"references-count":51,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["medicina58070863"],"URL":"https:\/\/doi.org\/10.3390\/medicina58070863","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,28]]}}}