The association between depression and suicide when hopelessness is controlled for

Abstract

Objective We retested the relationship between major depression and suicide with hopelessness as a control variable, with the hypothesis that the strong relationship between depression and suicide will decrease or disappear when hopelessness is controlled for. Also, hopelessness can be accounted for by psychological strains resulted from social structure coupled with individual characteristics. Method This was a case-control psychological autopsy study, in which face-to-face interviews were conducted to collect information from proxy informants for suicide victims and living subjects in rural Chinese 15–34 years of age who died of suicide (n=392) and who served as community living controls (n=416). Major depression was assessed by the Chinese version of the Structured Clinical Interview for DSM-IV (SCID). Hopelessness was measured by Beck Hopelessness Scale. Results A strong association between major depression and suicide was observed after adjustment for socio-demographic characteristics. When hopelessness was added to the analysis, the depression-suicide relationship was significantly decreased in all the six regression models. Conclusions Although depression as well as other mental illness is a strong risk factor for suicide, depression and suicide are both likely to be related to hopelessness, which in turn could be a consequence of psychological strains resulted from social structure and life events. Future studies may examine the causal relations between psychological strains and hopelessness.

The Beck Hopelessness Scale: Factor structure, validity and reliability in a non-clinical sample of student nurses in South-western Nigeria

“…The strength of our study is that this is the first study in Nigeria to examine the feasibility of the BHS, as an instrument for the evaluation of hopelessness in a non-clinical young adult sample of Nigerian student nurses. Our findings are in accordance with the results in published literature, which shows that individuals with higher levels of hopelessness are more likely to experience greater severity of depressive symptoms [52], psychological distress [53] and reduced self-worth [54]. We are of the opinion that there is the need to further examine the relationship between hopelessness and other psychosocial variables among the Nigerian nursing population (students and professionals).…”

Future‐directed thinking in first‐episode psychosis

“…Psychiatric disorder, especially depression, has been found to be present in up to 90% of those who complete suicide (Cavanagh et al, 2003), and it has been argued that this figure, though high, is an underestimate (Ernst et al, 2004;Flavio et al, 2013;Zhang & Li, 2013). Other factors associated with suicide are physical ill-health, male gender (though the opposite is true in DSH), older age, living alone, recent major life events, childhood maltreatment, alcohol misuse, and increased hopelessness (Hawton & van Heeringen, 2009;Nock et al, 2008).…”

“…Self-reported hopelessness has been shown to predict suicidal ideation, DSH and suicide completion in numerous studies (Beck, Steer, Kovacs, & Garrison, 1985;McMillan, Gilbody, Beresford, & Neilly, 2007;Petrie, Chamberlain, & Clarke, 1988;Salter & Platt, 1990;Zhang & Li, 2013). Furthermore, self-reported hopelessness has been shown to mediate the relationship between depression and suicide: a stronger relationship is found between measures of hopelessness and suicide behaviour than between measures of depression and suicide behaviour Beck et al, 1985;Minkoff, Bergman, Beck, & Beck, 1973).…”

Medically Serious Suicide Attempters With or Without Plan in Rural China

“…This may be a reason why mental disorder was not significant in our study. The other reason may be the effect of hopelessness between mental disorder and suicide (Zhang et al, 2013). …”