ETUDE RECHERCHE Idées suicidaires et labilité de l'affect chez les personnes ayant fait une ou plusieurs tentatives de suicide et souffrant de troubles dépressifs majeurs

Research paper

Suicidal ideation and affect lability in single and multiple suicidal attempters with Major Depressive Disorder : An exploratory network analysis
D.Núñez ^ab J.L. Ulloa ^a S. Guillaume ^c E. Olié ^c A. Alacreu-Crespo ^c P. Courtet ^c

a Faculty of Psychology, Universidad de Talca, Chile.

^b Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay
^c Département d'Urgences & Post Urgence Psychiatrique, CHU Montpellier, University of Montpellier, France

Received 31 January 2020, Revised 28 March 2020, Accepted 1 April 2020, Available online 7 May 2020.

Highlights

• Affect lability and anxiety as trait were the most central psychopathological aspects in suicidal attempters with a primary diagnosis of Major Depressive Disorder.•

Suicidal ideation was specifically connected with anxiety as trait and hopelessness.

• There were some differences between the symptomatic profiles of repeaters and non-repeaters and also between high and low suicidal ideation.
• Emotional regulation difficulties might be suitable targets for early detecting and treating suicidal patients.

Abstract

Introduction: A better understanding of the specific contribution of risk factors to suicidal behavior could arise from analyzing suicidal ideation (SI) in clinical samples, and comparing single versus multiple suicide attempters through contemporary methods allowing complex and dynamical analyses of multiple and simultaneously interacting suicide risk factors.

Method: We explored associations among suicidal ideation (SI), affect lability and other suicide risk factors in 323 suicidal attempters diagnosed with major depressive disorder (MDD). We analyzed the network structure and centrality of the total sample, and compared single versus multiple attempters and subjects with low and high suicidal ideation.

Results: SI was connected with anxiety (trait) and hopelessness. Central nodes for global and specific groups were affect lability (from anxiety to depression), anxiety as a trait, and harm avoidance. We observed some specific differences between clinical profiles of repeaters and non-repeaters and significant network density between high and low SI.

Limitations: Because our cross-sectional design, we cannot establish casual relationships among variables. We only examined associations at group level but not at single subject level.

Conclusions: Affect lability (mainly the shifts from anxiety to depression) and trait anxiety were central in each estimated network. These symptoms might be suitable targets for early detecting and treating suicidal patients.

https://www.sciencedirect.com/science/article/abs/pii/S0165032720303177