Predictors of suicidal ideation severity among treatment-seeking young people with major depressive disorder: The role of state and trait anxiety

Abstract

Objective: Depression and suicidal ideation are closely intertwined. Yet, among young people with depression, the specific factors that contribute to changes in suicidal ideation over time are uncertain. Factors other than depressive symptom severity, such as comorbid psychopathology and personality traits, might be important contributors. Our aim was to identify contributors to fluctuations in suicidal ideation severity over a 12-week period in young people with major depressive disorder receiving cognitive behavioural therapy. Methods: Data were drawn from two 12-week randomised, placebo-controlled treatment trials. Participants ( N = 283) were 15–25 years old, with moderate to severe major depressive disorder. The primary outcome measure was the Suicidal Ideation Questionnaire, administered at baseline and weeks 4, 8 and 12. A series of linear mixed models was conducted to examine the relationship between Suicidal Ideation Questionnaire score and demographic characteristics, comorbid psychopathology, personality traits and alcohol use. Results: Depression and anxiety symptom severity, and trait anxiety, independently predicted higher suicidal ideation, after adjusting for the effects of time, demographics, affective instability, non-suicidal self-injury and alcohol use. Conclusions: Both state and trait anxiety are important longitudinal correlates of suicidal ideation in depressed young people receiving cognitive behavioural therapy, independent of depression severity. Reducing acute psychological distress, through reducing depression and anxiety symptom severity, is important, but interventions aimed at treating trait anxiety could also potentially be an effective intervention approach for suicidal ideation in young people with depression.

Trait anxiety predicting the developmental trajectories of depression symptoms in children: The mediating role of attentional control

“…A study recruited young people aged 15 to 25 years who received randomized controlled treatment for moderate to severe major depressive symptoms. The study found that higher trait anxiety predicted higher suicidal ideation (Moller et al, 2023). The findings showed that high trait anxiety might precede and prospectively affect the development of depression symptoms, thus providing some evidence for the predictive values of trait anxiety for the developmental trajectories of depression symptoms.…”

“…Similarity with previous literature Consistent with the hypothesis, trait anxiety was a significant predictor of the trajectory of depression symptoms during the transition into early adolescence. Previous studies have supported the transdiagnostic risk factor for trait anxiety for the development of depression symptoms (Carmela et al, 2022;Malhi et al, 2021 b;Moller et al, 2023;Wang et al, 2019 a). For example, a study with 178 depressive patients revealed that higher trait anxiety was associated with slower recovery from depression after treatment (Min et al, 2012).…”

Australian Men’s Help-Seeking Pathways for Anxiety

“…In a longitudinal evaluation of loneliness and social anxiety, Lim et al (2016) reported that loneliness is predictive of future social anxiety, but conversely, early social anxiety is also an independent predictor of future loneliness (which was not seen for depression or paranoia). Given loneliness and anxiety both constitute concerning risks for poor health outcomes (i.e., cardiovascular disease, dementia, cognitive decline; National Academies of Sciences Engineering and Medicine, 2020) and suicide (Kealy et al, 2021;Moller et al, 2023), it is critical that future research adequately considers, and further disentangles, the discrete yet interconnected nature of loneliness and anxiety in men.…”