Decline in suicidal ideation among patients with MDD is preceded by decline in depression and hopelessness

Sokero, Petteri; Eerola, Mervi; Rytsälä, Heikki; Melartin, Tarja; Leskelä, Ulla; Lestelä-Mielonen, Paula; Isometsä, Erkki

doi:10.1016/j.jad.2006.04.028

Cited by 58 publications

(45 citation statements)

References 40 publications

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“…Our results are consistent with findings demonstrating that negative affect intensity and reactivity is associated with suicidal ideation in older adults [11] and that increased negative emotions are associated with suicidal ideation and behavior in young and older adults [17,29–31] . Our findings reveal that reduction in suicidal ideation was similar in both study arms despite differential change in improvement in negative emotions.…”

Section: Discussionsupporting

confidence: 93%

Negative Emotions and Suicidal Ideation during Psychosocial Treatments in Older Adults with Major Depression and Cognitive Impairment

Kiosses

Gross

Banerjee

et al. 2017

The American Journal of Geriatric Psychiatry

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Objectives To examine the relationship of negative emotions with suicidal ideation during 12-weeks of Problem Adaptation Therapy (PATH) vs. Supportive Therapy of Cognitively Impaired Older Adults (ST-CI). We hypothesize that: a) improved negative emotions are associated with reduced suicidal ideation; b) PATH improves negative emotions more than ST-CI; and c) improved negative emotions, rather than other depression symptoms, predict reduction in suicidal ideation. Design RCT of two home-delivered psychosocial interventions. Setting Weill-Cornell Institute of Geriatric Psychiatry; interventions and assessments were conducted at participants’ home. Participants 74 older participants (65–95 years old) with MDD and cognitive impairment were recruited in collaboration with community agencies. The sample reported less intense feelings than suicidal intention. Interventions PATH focuses on improving emotion regulation whereas ST-CI focuses on non-specific therapeutic factors, such as understanding and empathy. Measurements Improved negative emotions are measured as improvement in Montgomery Asberg’s Depression Rating Scales’ (MADRS) observer-ratings of sadness, anxiety, guilt, hopelessness and anhedonia. Suicidal ideation was assessed with the MADRS Suicide Item. Results MADRS Negative Emotions scores were significantly associated with suicidal ideation during the course of treatment (F[1, 165]=12.73, p=0.0005). PATH participants had significantly greater improvement in MADRS emotions than ST-CI participants (treatment group by time: F[1,63.2]=7.02, p=0.0102). Finally, improved negative emotions, between lagged and follow-up interview, significantly predicted reduction in suicidal ideation at follow-up interview (F[1, 96]=9.95, p=0.0022). Conclusions Our findings that improvement in negative emotions mediates reduction in suicidal ideation may guide the development of psychosocial interventions for reduction of suicidal ideation.

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Section: Discussionsupporting

confidence: 93%

Negative Emotions and Suicidal Ideation during Psychosocial Treatments in Older Adults with Major Depression and Cognitive Impairment

Kiosses

Gross

Banerjee

et al. 2017

The American Journal of Geriatric Psychiatry

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“…High level of hopelessness was the only factor differentiating the chronic ideation group from the elevated but fast declining group. The idea that holding negative expectations about the future may be maintaining suicidal thoughts is also supported by a previous study of depressed psychiatric adult patients, where declines in hopelessness preceded declines in suicidal ideation (Sokero et al, 2006). It is also possible that enduring suicidal thoughts may be maintained by a related ruminative process that prolongs negative mood and impedes faster declines in suicidal thinking.…”

Section: Discussionmentioning

confidence: 66%

Longitudinal Trajectories of Suicidal Ideation and Subsequent Suicide Attempts Among Adolescent Inpatients

Czyz

King

2013

Journal of Clinical Child & Adolescent Psychology

122

100

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Objective A period of particularly high risk for suicide attempts among adolescent inpatients is within 12 months after discharge. However, little is known about longitudinal trajectories of suicidal ideation in this high-risk group and how these relate to post-hospitalization suicide attempts and rehospitalizations. Our objectives were to identify these trajectories and examine their relationships with post-hospitalization psychiatric crises. We also examined predictors of trajectory group membership. Method Participants (N=376; ages 13-17; 72% females) were assessed at hospitalization and 3, 6, and 12 months later. Trajectory groups, and their predictors, were identified with latent class growth modeling. We used logistic regression to examine associations between trajectory groups and likelihood of suicide attempts and rehospitalization, controlling for attempt history. Results Three trajectory groups were identified: (1) subclinical ideators (31.6%); (2) elevated ideators with rapidly declining ideation (57.4%); and (3) chronically elevated ideators (10.9%). Adolescents in the chronically elevated ideation group had 2.29[(CI=1.08,4.85), p=0.03] and 4.15[(CI=1.65,10.44), p<0.01] greater odds of attempting suicide and 3.23[(CI=1.37,7.69), p=0.01] and 11.20[(CI=4.33,29.01), p<0.001] greater odds of rehospitalization relative to rapidly declining and subclinical groups, respectively. Higher baseline hopelessness was associated with persisting suicidal ideation. Conclusions Results suggest that suicidal ideation severity at hospitalization may not be an adequate marker for subsequent suicidal crises. It is important to identify adolescents vulnerable to persisting suicidal ideation, as they are at highest risk of psychiatric crises. Addressing hopelessness may facilitate faster declines in ideation after hospitalization. Results also highlight a need for consistent monitoring of these adolescents' suicidal ideation after discharge.

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“…Moreover, the interaction between negative cognitive styles and negative life events contributes to a sense of hopelessness. This state often causes depression and is present during episodes of major depression . Several studies have confirmed that hopelessness is a predictor of suicide attempts .…”

Section: Introductionmentioning

confidence: 99%

Suicidal ideation, perceived disability, hopelessness and affective temperaments in patients affected by Parkinson's disease

et al. 2018

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Summary Background Previous studies investigating the risk of suicide in patients with Parkinson's disease (PD) have reported conflicting results. This study evaluated suicide risk in PD and investigated the relationship between suicide risk and perceived disability, hopelessness and affective temperaments in PD. Methods One‐hundred and twenty PD patients were consecutively enrolled. The diagnosis of PD was based on clinical criteria. All patients underwent a psychiatric evaluation that included the administration of the Columbia‐Suicide Severity Rating Scale, the Italian Perceived Disability Scale, the Beck Hopelessness Inventory and the TEMPS‐A questionnaire. The results were compared with those of a control group of 91 patients affected by another chronic disease, ie, open angle glaucoma. Results Parkinson's disease patients had higher suicidal ideation, higher perceived disability and lower hyperthymia than the control group. In PD, higher perceived disability was associated with higher current and lifetime suicidal ideation, lower hyperthymia, older age and higher scores on negative temperaments. Suicidal ideation, negative temperaments and hopelessness were risk factors for perceived disability, while hyperthymia was a protective factor for perceived disability. Discussion Patients with PD have an increased risk of suicidal ideation. Increased suicidal ideation in PD is associated with the increased perceived disability. A psychiatric assessment that includes the investigation of suicide risk and perceived disability is recommended in patients with PD.

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Decline in suicidal ideation among patients with MDD is preceded by decline in depression and hopelessness

Cited by 58 publications

References 40 publications

Negative Emotions and Suicidal Ideation during Psychosocial Treatments in Older Adults with Major Depression and Cognitive Impairment

Negative Emotions and Suicidal Ideation during Psychosocial Treatments in Older Adults with Major Depression and Cognitive Impairment

Longitudinal Trajectories of Suicidal Ideation and Subsequent Suicide Attempts Among Adolescent Inpatients

Suicidal ideation, perceived disability, hopelessness and affective temperaments in patients affected by Parkinson's disease

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