Hopelessness in suicide attempters after acute treatment of major depression in late life

Abstract

The relation between hopelessness and suicide attempts in the elderly was examined by studying the course of hopelessness in depressed patients. Sixty-three elderly patients with recurrent major depression were treated with nortriptyline and interpersonal psychotherapy and underwent serial ratings of hopelessness and depression during the acute and continuation phases of treatment. Patients who had made a suicide attempt in the past had significantly higher hopelessness scores than nonattempters during both phases of treatment. They were also more likely to drop out of treatment. A high degree of hopelessness persisting after remission of depression in elderly patients appears to be associated with a history of suicidal behavior. It may also increase the likelihood of premature discontinuation of treatment and lead to future suicide attempts or suicide.

Emergency Room Validation of the Revised Suicide Trigger Scale (STS-3): A Measure of a Hypothesized Suicide Trigger State

“…This is consistent with both the face-value relatedness of core content of the subscale items, and with multiple studies wherein depression, hopelessness, and anxiety were found to be the most common and strongest predictors of suicidal ideation, suicidal attempt, and suicidal intent [7], [22], [29]–[31]. Frantic Hopelessness, however, differs from simple anxiety and depression by its sense of urgency.…”

Core belief content examined in a large sample of patients using online cognitive behaviour therapy

“…Findings indicated that the core schema dimensions of social isolation/alienation, defectiveness/shame, failure, dependence/incompetence, subjugation of needs, emotional inhibition, and unrelenting standards were positively correlated with suicidal ideation. In a sample of individuals with major depression in later life, those who had attempted suicide in the past were more likely to report feelings of hopelessness (Rifai et al, 1994). Furthermore, predictive links have been found between hopelessness and negative self-concept and suicide (Beck and Weishaar, 1990).…”

Self-Rated Depression Severity Relative to Clinician-Rated Depression Severity: Trait Stability and Potential Role in Familial Transmission of Suicidal Behavior

“…There is disagreement over whether hopelessness is related to suicidal behavior, especially after adjustment for current severity of depression (Kuo et al, 2004;Szanto, Reynolds, Conwell, Begley, & Houck, 1998;Wetzel, 1976). A trait dimension to hopelessness is suggested by its remaining relatively higher in suicide attempters compared with nonattempters, even after depression treatment response (Rifai, George, Stack, Mann, & Reynolds, 1994;Szanto et al, 1998;Young et al, 1996), and there is a stable rank order of hopelessness severity over 2 years in the general population (Young et al, 1996).…”