Despair Beyond Repair? Severity Of Hopelessness In Depressed Psychiatric Inpatients.

Abstract

Background: Depression is related to suicidal ideation, attempts, and completion. However, depression fails to provide any specific identification for suicide risk. Hopelessness has been found to provide a more accurate estimate of suicide risk than seen in depression severity, and hopelessness can serve as a useful predictor of eventual death by suicide. Aims: The present study was designed to examine various levels of hopelessness and their association with other symptoms experienced by depressed psychiatric inpatients. Method: 150 adult psychiatric inpatients were evaluated using a structured diagnostic interview and several standardized self-report questionnaires. All patients met criteria for a depressive diagnosis at the time of the evaluation. Patients were classified into four discrete categories of hopelessness using the Beck Hopelessness Scale. Results: No differences were observed when the four groups of depressed psychiatric inpatients were compared on demographic variables and background clinical events. However, several key differences were observed between groups on measures of depression severity, suicidal ideation, and tendencies to cope by distraction.Conclusions: It appears useful to evaluate suicide risk as it changes across different levels of hopelessness. Depressed patients with higher levels of hopelessness report more severe problems on several dimensions related to suicide risk.

Newly diagnosed patients with advanced non-small cell lung cancer: A clinical description of those with moderate to severe depressive symptoms

“…Additionally, these patients' levels of hopelessness were notably higher than those found in non-illness comparison samples [60]. Nearly half (47 %) reported moderate or severe hopelessness, signified by BHS scores ≥ 9; for comparison, Overholser et al [61] and Fisher et al [62] reported mean BHS scores of 10-11 among depressed psychiatric patients. Hopelessness is a particularly important reponse in this cancer group, as it predicts depressive symptoms throughout the disease trajectory [63] and suicidal ideation [64].…”

Specific depression dimensions are associated with a faster rate of cognitive decline in older adults

“…Although our results did not show any significant long‐term decline with dysphoria, the hopelessness dimension was associated with a faster rate of decline in all cognitive domains. This may be explained at least in part by the possibility that the hopelessness dimension in this study included more severe depressive symptoms, that is, feelings of helplessness, worthlessness, and hopelessness 31 . Hopelessness is defined as one's negative bias toward the future as opposed to the negative bias toward the self (worthlessness) or the world 32 .…”

“…This may be explained at least in part by the possibility that the hopelessness dimension in this study included more severe depressive symptoms, that is, feelings of helplessness, worthlessness, and hopelessness. 31 Hopelessness is defined as one's negative bias toward the future as opposed to the negative bias toward the self (worthlessness) or the world. 32 Hopelessness, more recently included in the definition of core depressed mood in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5), 33 has been identified as the key factor linking depression to suicidal behavior 34 and is reported to be associated with poor outcomes in health and social functioning, 35 as well as medical conditions such as congestive heart failure and heart attack, independently of other depressive symptoms.…”