Prevalence and correlates of suicide ideation in patients with COPD: a mixed methods study

Sara Fleehart, Vincent S. Fan, Huong Q. Nguyen, Jungeun Lee, Ruth Kohen, Jerald R. Herting, Gustavo Matute-Bello, Sandra G Adams, Genevieve Pagalilauan, Soo Borson

Research output: Contribution to journalArticle

19 Scopus citations


PURPOSE: The purpose of this study was to examine the prevalence and correlates of suicidal ideation (SI) in patients with stable moderate to very severe chronic obstructive pulmonary disease (COPD).

PATIENTS AND METHODS: We conducted an exploratory mixed methods analysis of data from participants in a longitudinal observational study of depression in COPD. We measured depression with the Patient Health Questionnaire-9 (PHQ-9), which includes an item on SI. We compared participants with and without SI in relation to sociodemographics, symptoms, anxiety, and healthcare resource use with independent t-tests and chi-square tests. Content analysis was performed on qualitative data gathered during a structured SI safety assessment.

RESULTS: Of 202 participants, 121 (60%) had depressive symptoms (PHQ ≥6); 51 (25%) had a PHQ-9 ≥10, indicating a high likelihood of current major depression; and 22 (11%) reported SI. Compared to the 99 depressed participants without SI, those with SI were more likely to be female (59% vs 27%, P=0.004); had worse dyspnea (P=0.009), depression (P

CONCLUSION: Our findings suggest that current SI is common in COPD, may occur disproportionately in women, can persist despite mental health treatment, and has complex relationships with both health and life events. Adequate management of SI in COPD may therefore require tailored, comprehensive treatment approaches that integrate medical and mental health objectives.

Original languageEnglish (US)
Pages (from-to)1321-1329
Number of pages9
JournalInternational journal of chronic obstructive pulmonary disease
StatePublished - 2015
Externally publishedYes



  • chronic obstructive
  • depression
  • PHQ-9
  • pulmonary disease
  • qualitative
  • suicide

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Fleehart, S., Fan, V. S., Nguyen, H. Q., Lee, J., Kohen, R., Herting, J. R., Matute-Bello, G., Adams, S. G., Pagalilauan, G., & Borson, S. (2015). Prevalence and correlates of suicide ideation in patients with COPD: a mixed methods study. International journal of chronic obstructive pulmonary disease, 10, 1321-1329.