Clinical Dimensions Associated With Psychological Pain in Suicidal Patients
Abstract : Objective:
Psychological pain is a transdiagnostic factor in mental health and a
key clinical dimension to understand suicide in patients with mood
disorders. However, less is known about the clinical characteristics
that predict high psychological pain. The aim of this study was to fill
this gap in a sample of patients with mood disorders.
Methods: Inpatients admitted for a major depressive episode, according
to DSM-IV criteria, from 2010 to 2017 were divided into 3 groups: 178
recent suicide attempters (within the last 7 days), 101 past suicide
attempters (lifetime history of suicide attempt), and 93 nonattempters
(no lifetime history of suicidal act). At inclusion, current
psychopathology, medication, personality traits (impulsivity, anxiety,
hopelessness), and childhood trauma were assessed. At inclusion and at
1-year follow-up, depressive symptomatology and current and maximal
(within the 15 last days) psychological and physical pain were assessed.
Results: At baseline, maximal psychological pain was higher in recent
than in past suicide attempters (odds ratio [OR] = 1.18 [1.04-1.35]) and
nonattempters (OR = 1.32 [1.16-1.50]). In the multivariate model,
depression severity (OR = 1.11 [1.08-1.16]) and worst physical pain (OR =
2.53 [1.28-5.02]) predicted high psychological pain, whereas bipolar
disorder (OR = 0.54 [0.29-0.98]) predicted low psychological pain.
During the follow-up, the change in maximal psychological pain was
predicted by changes in depressive symptomatology (β = 0.46, P <
.001) and maximal physical pain (β = 0.42, P < .003). Finally, among
depressive symptoms, guilt, lack of initiative, and loss of appetite
better explained maximal psychological pain, both at inclusion and at 1
year (all P < .050).
Conclusions: Psychological pain is associated with a recent suicidal act
and depressive severity. Due to the strong link between psychological
pain and physical pain, future studies should investigate whether
psychotropic drugs with analgesic effects protect from psychological pain and therefore from suicide.
HAL Id : hal-03577729, version 1
DOI : 10.4088/JCP.21m14065
PUBMED : 35143124
Collections UNIV-MONTPELLIER | CNRS
Citation
Adrián Alacreu-Crespo, Sebastien Guillaume, Stephane Richard-Devantoy, Aurelie Cazals, Emilie Olié, et al.. Clinical Dimensions Associated With Psychological Pain in Suicidal Patients. Journal of Clinical Psychiatry, the American Society of Clinical Psychopharmacology, 2022, 83 (2), pp.21m14065. ⟨10.4088/JCP.21m14065⟩. ⟨hal-03577729⟩
DOI : 10.4088/JCP.21m14065
PUBMED : 35143124
Collections UNIV-MONTPELLIER | CNRS
Citation
Adrián Alacreu-Crespo, Sebastien Guillaume, Stephane Richard-Devantoy, Aurelie Cazals, Emilie Olié, et al.. Clinical Dimensions Associated With Psychological Pain in Suicidal Patients. Journal of Clinical Psychiatry, the American Society of Clinical Psychopharmacology, 2022, 83 (2), pp.21m14065. ⟨10.4088/JCP.21m14065⟩. ⟨hal-03577729⟩
Soumis le : mercredi 16 février 2022