Relationships between anhedonia, suicidal ideation and suicide attempts in a large sample of physicians

Abstract

BackgroundThe relationships between anhedonia and suicidal ideation or suicide attempts were explored in a large sample of physicians using the interpersonal psychological theory of suicide. We tested two hypotheses: firstly, that there is a significant relationship between anhedonia and suicidality and, secondly, that anhedonia could mediate the relationships between suicidal ideation or suicide attempts and thwarted belongingness or perceived burdensomeness.MethodsIn a cross-sectional study, 557 physicians filled out several questionnaires measuring suicide risk, depression, using the abridged version of the Beck Depression Inventory (BDI-13), and demographic and job-related information. Ratings of anhedonia, perceived burdensomeness and thwarted belongingness were then extracted from the BDI-13 and the other questionnaires.ResultsSignificant relationships were found between anhedonia and suicidal ideation or suicide attempts, even when significant variables or covariates were taken into account and, in particular, depressive symptoms. Mediation analyses showed significant partial or complete mediations, where anhedonia mediated the relationships between suicidal ideation (lifetime or recent) and perceived burdensomeness or thwarted belongingness. For suicide attempts, complete mediation was found only between anhedonia and thwarted belongingness. When the different components of anhedonia were taken into account, dissatisfaction—not the loss of interest or work inhibition—had significant relationships with suicidal ideation, whereas work inhibition had significant relationships with suicide attempts.ConclusionsAnhedonia and its component of dissatisfaction could be a risk factor for suicidal ideation and could mediate the relationship between suicidal ideation and perceived burdensomeness or thwarted belongingness in physicians. Dissatisfaction, in particular in the workplace, may be explored as a strong predictor of suicidal ideation in physicians.

Anhedonia and suicidal thoughts and behaviors in psychiatric outpatients: The role of acuity

“…() suggest that a more precise distinction can be found when focusing on recent changes in anhedonia, which is more accurately captured by the Specific Loss of Interest and Pleasure Scale (SLIPS) and the Beck Depression Inventory's (BDI) anhedonia subscale (items 4, 12, and 21). Several of the studies indicating a positive relationship between anhedonia and STB used these measures (Gabbay et al., ; Loas, Lefebvre, Rotsaert, & Englert, ; Winer et al., ; Winer, Drapeau, Veilleux, & Nadorff, ; Yaseen et al., ; Zielinski et al., ), providing support for the hypothesis that increased risk of STB is associated with acute anhedonic state. However, these studies do not address the role of trait anhedonia.…”

Stress and Suicidal Ideation: The Role of State or Trait Anhedonia in a Moderated Mediation Model

“…Some studies found that State‐A (recent changes and acuity) was especially predictive of suicidal ideation independently of depressive symptoms (Ducasse et al, ; Hawes et al, ; Winer et al, ; Winer et al, ). Other studies found that State‐A mediated the positive association between depressive symptoms/perceived burdensomeness/thwarted belongingness and suicidality (Loas et al, ; Zielinski et al, ). In the current study, state anhedonia moderated the indirect association between stress and SI.…”

“…Anhedonia, defined as a lowered ability to experience pleasure, has been identified as a suicide risk factor (Loas, ). Recent works suggested taking into account the severity and the type of anhedonia when examining suicidal ideation (SI) (Ducasse et al, ; Loas et al, ). Anhedonia has been defined as both a state and a trait, dependent on whether it is thought of as an aspect of a depressive state or a personality trait (Loas & Pierson, ).…”

Anhedonia across borders: Transdiagnostic relevance of reward dysfunction for noninvasive brain stimulation endophenotypes

“…As discussed, anhedonia has a relevant impact on patients’ quality of life. It worsens the rate of suicidal ideation in different samples and determines poor social functioning and higher and prolonged hospitalization …”