伴炎症性抑郁精神分裂症患者的临床特征及其影响因素

目的:探讨伴发炎症性抑郁的精神分裂症患者临床特征及其影响因素。方法:来自3家医院的慢性精神分裂症患者330例中,87例精神分裂症抑郁量表(CDSS)总分≥5,诊断为伴发抑郁症状的精神分裂症;其中25例血浆超敏C反应蛋白(hs-CRP)≥3 mg/L归入炎症性抑郁组,62例血浆hs-CPR3 mg/L归入非炎症性抑郁组;比较两组人口学(性别、年龄、受教育年限、婚姻状况等)及临床资料[发病年龄、病程、体质量指数(BMI)、因精神分裂症住院次数、自杀状况、躯体疾病(冠心病、心力衰竭、高血压、糖尿病、脑卒中、肿瘤等)、用药情况等]、血液生化指标(血糖、血脂、食欲素A、瘦素)、阳性和阴性症状量表(PANSS)及失眠严重指数(ISI)评分,分析伴发炎症性抑郁的影响因素。结果:与非炎症性抑郁组相比,炎症性抑郁组BMI、血浆食欲素A及瘦素水平明显增高,服用的抗精神病药氯丙嗪等效剂明显量降低(P均0.05);二分类Logistic回归显示,高瘦素水平(OR=1.375,95%CI:1.022～1.850,P=0.035)、低氯丙嗪等效剂量(OR=0.997,95%CI:0.994～0.999,P=0.013)是炎症性抑郁的影响因素。结论:高瘦素水平及服用低剂量抗精神病药可能是精神分裂症患者伴发炎症性抑郁的危险因素。     

首发未治疗抑郁症患者自杀风险与情感气质的关系

目的探讨抑郁症患者自杀风险在情感气质特征方面的危险因素。方法来自我院门诊103例首发未治疗抑郁症患者,根据简明国际神经精神访谈(the mini international neuropsychiatric interview,MINI)5.0中文版自杀模块访谈结果,分为有自杀风险组和无自杀风险组。用情感气质量表(temperament evaluation of the Memphis,Pisa,Paris,and San Diego-auto questionnaire,TEMPS-A)评估情感气质,用汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD)评估抑郁症状的严重程度。结果 45.6%(47/103)的抑郁症患者伴有自杀风险。与无自杀风险组患者相比,有自杀风险组患者女性、无业及未婚者较多,发病年龄较早,HAMD总分以及TEMPSA中循环气质、抑郁气质、焦虑气质评分较高(均P 0.05)。logistic回归分析显示,女性(OR=3.392,95%CI:1.246～9.232)、发病年龄(OR=0.924,95%CI:0.844～0.966)、HAMD总分(OR=1.134,95%CI:1.022～1.258)和循环气质评分(OR=1.204,95%CI:1.015～1.427)与自杀风险相关。结论女性、发病年龄早、抑郁症状严重和循环气质突出可能为首发抑郁症患者自杀风险的危险因素。     

公寓老年人中抑郁症候群与自杀意念的关联研究

目的:探讨公寓老年人群中抑郁症候群和自杀意念的关系. 方法:采用老年抑郁量表(GDS)和自编自杀意念调查问卷对哈尔滨市2所老年公寓的221名老年人进行问卷调查.运用Logistic回归和Spearman相关进行数据分析. 结果:抑郁症候群与是否发生自杀意念相关(r=0.437,P＜0.0001),与自杀意念等级也相关(r=0.469,P=0.01).多因素Logistic回归分析表明,影响自杀意念发生的抑郁症状有:放弃了许多活动与兴趣(P=0.01,OR =4.19)、常感到孤立无援(P=0.00,OR =3.17)、觉得未来有希望(P=0.00,OR =0.19)、觉得现在活着很惬意(P=0.03,OR =0.31). 结论:公寓老年人群自杀意念发生和加重与抑郁症候群关系较为密切.     

精神分裂症患者病耻感与自杀观念的关系

目的探讨精神分裂症患者感知的病耻感与自杀观念的关系,为精神分裂症的心理康复和自杀预防提供参考。方法采用方便入组的方法入组2010年2月-2014年10月在天津市滨海新区塘沽安定医院和北京回龙观医院门诊和住院治疗的精神分裂症患者121例,采用阳性和阴性症状量表(PANSS)、汉密尔顿抑郁量表17项版(HAMD-17)以及Link贬低-歧视感知量表(PDD)进行评定。结果 1与无自杀观念的精神分裂症患者相比,有自杀观念的患者PPD评分更高[(4.21±1.11)分vs.(3.09±1.01)分,t=5.71,P0.01]、自知力评分更低[(3.55±1.34)分vs.(4.83±1.26)分,t=5.41,P0.01],精神分裂症患者的自杀观念与PDD评分(r=0.46,P0.01)、自知力(r=-0.44,P0.01)及抑郁症状评分(r=0.30,P0.01)相关;2多元Logistic回归结果显示,精神分裂症患者的PDD评分越高(B=1.14,OR=3.13,P0.01,95%CI:1.86~5.25)、抑郁症状评分越高(B=0.11,OR=1.11,P=0.01,95%CI:1.02~1.22)、自知力越完整(B=-0.76,OR=0.47,P0.01,95%CI:0.32~0.70),自杀观念的风险越大(Logistic回归模型R2=0.51,P0.01)。结论精神分裂症患者感知病耻感的水平越高,可能存在自杀观念的风险越大。     

伴焦虑症状抑郁症患者自杀未遂的危险因素

目的分析伴焦虑症状抑郁症患者自杀未遂的人口学资料及临床特征方面的危险因素。方法来自全国13个中心的728例伴有焦虑症状抑郁症患者,根据简明国际神经精神访谈(mini international neuropsychiatric interview,MINI)5.0中文版自杀模块,评估其是否有自杀未遂行为。采用多因素logistic回归,分析伴焦虑症状抑郁症患者在性别、年龄、民族等人口学资料及伴精神病性症状、伴不典型特征等临床特征方面可能与自杀未遂相关的危险因素。结果伴焦虑症状抑郁症患者中,135例(18.5%)有自杀未遂,593例(81.5%)无自杀未遂。有自杀未遂组与无自杀未遂组相比,起病年龄早[(32.3±11.9)vs.(35.3±13.1)],既往抑郁发作次数多(中位数:2 vs.2),既往住院次数多(中位数:1 vs.0),更多患者出现抑郁发作频繁(14.8%vs.7.4%),更常伴不典型症状(25.9%vs.15.0%)和伴自杀意念(78.5%vs.50.3%),应用抗抑郁剂治疗者更多见(81.5%vs.71.2%),差异均具有统计学意义(P0.05)。Logistic回归分析显示,伴焦虑症状抑郁症患者既往住院次数多(OR=1.18,95%CI:1.02~1.37)、抑郁发作频繁(OR=2.05,95%CI:1.14~3.68)、伴自杀意念(OR=3.55,95%CI:2.28~5.54)与自杀未遂相关联(P0.05)。结论既往住院次数多、抑郁发作频繁、伴自杀意念可能是伴焦虑症状抑郁症患者自杀未遂的危险因素。     

精神障碍患者自杀意念与失眠关系研究

目的探讨精神障碍患者中自杀意念与失眠的关系。方法选取559例住院精神障碍患者,采用Beck自杀意念量表评估自杀情况,以ICD-10中失眠症诊断标准诊断失眠症,采用匹茨堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评估睡眠质量。分析有无自杀意念精神障碍患者失眠症发生情况,及失眠和自杀意念的相关性。结果受试者中32例有自杀意念。自杀意念组与非自杀意念组失眠症的发生率差异有统计学意义(31.3%vs.10.1%,χ~2=13.55,P0.01);自杀意念组PSQI评分高于非自杀意念组(9.16±4.75 vs.5.56±3.71,t=5.24,P0.01)。多因素logistics回归分析示PSQI评分与自杀意念相关联(OR=1.21,95%CI:1.12~1.32,P0.01)。结论精神障碍患者自杀意念与失眠相关。     

山东农村居民自杀意念的发生率及其危险因素研究

目的 了解农村居民自杀意念的发生率及其危险因素,为自杀干预提供依据.方法 采用包括一般健康状况问卷、冲动性和攻击性量表、社会支持量表、家庭亲密度与适应性量表等对山东滕州市东郭镇19个村≥15岁的5039例农村居民进行自杀意念及其相关因素的调查,以多因素logistic模型分析自杀意念的危险因素.结果 在农村居民中,9.33%(470/5039)在过去任何时候有过自杀意念(95%CI:8.52%～10.13%),5.39%(299/5039,95%CI:5.28%～6.59%)近1年有过自杀意念.近1年自杀意念的危险因素排列为:近1年慢性压力大(OR=5.61,95%CI:4.04～7.78),攻击性高(OR=2.54,95%CI:1.93～3.35),非现婚状态(OR=2.04,95%CI:1.52～2.76),生命质量低(OR=1.86,95%CI:1.40～2.48),女性(OR=1.76,95%CI:1.34～2.32),自我感觉经济状况差(OR=1.70,95%CI:1.29～2.25),认识的人中有自杀(OR=1.53,95%CI:1.17～1.99),家庭亲密度低(OR=1.38,95%CI:1.06～1.80).结论 农村居民自杀意念发生率处于较高水平.慢性压力大、攻击性高、非现婚状态是近1年自杀意念最主要的危险因素.应根据其危险因素制订有针对性的干预计划.     

精神分裂症抑郁症状的识别与诊断——四种抑郁量表的比较

目的 比较四种抑郁量表对精神分裂症抑郁症状的诊断效能.方法 100例符合CCMD-3精神分裂症诊断标准的患者进入研究,以CCMD-3抑郁发作标准判断是否存在有抑郁症状,同时进行CDSS-C、MADRS、HAMD-24、PANSS及RSESE测评.结果 (1)100例患者中符合CCMD-3抑郁发作标准诊断抑郁者22人,抑郁发生率为22％;(2)CDSS-C、MADRS、HAMD-24、PANSS-G相互之间相关性均较高,但只有CDSS-C与PANSS-N、阴性症状各条目及RSESE无相关;(3) CDSS-C与MADRS、HAMD- 24、PANSS- G6的工作特征曲线下面积(AUROC)分别为:0.933、0.826、0.883及0.887,CDSS-C的AUROC要明显高于其他三个抑郁量表(P＜0.05).结论 CDSS-C是较理想的测评精神分裂症抑郁症状的工具,可在临床尝试使用.     

抑郁症住院患者的自杀意念现状分析

目的 探究住院抑郁症患者自杀意念的影响因素。方法 招募66例住院抑郁症患者,根据Beck自杀意念量表将其分为有自杀意念组（40例）,无自杀意念组（26例）,采用17项汉密尔顿抑郁量表、汉密尔顿焦虑量表、Beck绝望量表、生存理由量表中文版对两组患者进行评估。结果 (1)有自杀意念组患者的抑郁评分显著高于无自杀意念组患者,有统计学差异（P<0.05）,两组焦虑评分无统计学差异（P>0.05）;(2)有自杀意念组患者对未来的感觉、对未来的期望因子评分和总分显著高于无自杀意念组患者（P<0.05）,两组动机的丧失因子评分无统计学差异（P>0.05）;(3)有自杀意念组患者的生存和应对信念、对子女的考虑、对社会排斥的恐惧、道德反对因子评分和总分显著低于无自杀意念组患者,有统计学差异（P<0.05）;(4) Logistic回归分析结果显示：生存和应对信念是自杀意念的保护性因素。结论 在临床中可以尝试通过帮助患者寻找生存和应对信念,找到生活的意义,来应对绝望的感觉,从而对自杀进行干预。     

重性抑郁障碍患者血清胆固醇水平与抑郁、自杀意念的相关分析

目的:探讨重性抑郁障碍(MDD)患者血清总胆固醇(TC)水平与抑郁、自杀意念的相关性。方法:收集108例MDD患者的一般及临床资料,检测其血清TC水平,并据此分为TC异常组和TC正常组,采用汉密尔顿抑郁量表-17项(HAMD-17)、自杀意念自评量表(SIOSS)对两组患者进行评定;采用Logistic回归方法对各相关因素进行分析。结果:入组的MDD患者中,44例(40. 7%)入TC异常组,64例入TC正常组; TC异常组HAMD-17总分及其中焦虑/躯体化、认知障碍、睡眠障碍因子分、以及SIOSS总分显著高于TC正常组(P均0. 01);以血清TC水平为因变量的Logistic回归分析显示,HAMD中的焦虑/躯体化因子和SIOSS总分纳入方程(P 0. 05或P 0. 01)。结论:MDD患者血清TC水平越高,其焦虑/躯体化症状和自杀意念越重。     

Suicidal ideation in medical inpatients: psychosocial and clinical correlates

Objective

To identify psychosocial and clinical correlates of suicidal ideation in medical inpatients.

Method

In a cross-sectional study, all adults consecutively admitted to the medical wards of a University Hospital had their names recorded and were randomized and evaluated during the first week of admission. Suicidal ideation was assessed using Item 9 of Patient Health Questionnaire-9. The Beck Depression Inventory, the Beck Anxiety Inventory, the WHO Subjective well-being scale, the Charlson Comorbidity Index and other numerical rating scales (pain and self-reported physical illness severity) were used. Patients with less than four confidants were considered with poor social support. The Student's t test, Mann-Whitney U test, chi-square test and stepwise logistic regression analysis were used.

Results

Of the 1092 patients who composed the sample, 7.2% reported having suicidal ideation. After adjusting for psychosocial and clinical confounders, prior suicide attempts (OR: 4.41; 95% CI: 2.12–9.15; P<.001), depressive symptoms (OR: 1.11; 95% CI: 1.06–1.17; P<.001), severe anxiety symptoms (OR: 3.04; 95% CI: 1.47–6.26; P=.003) and poor social support (OR: 2.02; 95% CI:1.03–3.96; P=.04) were independently associated with suicidal ideation.

Conclusions

Three out of the four correlates of suicidal ideation in medical inpatients are potentially modifiable factors: severe anxiety, depressive symptoms and poor social support. The fourth variable, prior suicide attempts, is not modifiable but should serve as a red flag to suspect and investigate current suicide risk. These findings highlight the importance of suicidal ideation as a proxy for the distress that is incumbent upon physicians to manage if they wish to provide excellent and comprehensive inpatient care.     

Suicidal ideation in inpatients with acute schizophrenia.

OBJECTIVE: Schizophrenia has been associated with a high rate of suicide. This study investigates the prevalence of suicidal ideation in a population of inpatients with acute schizophrenia, together with the clinical parameters associated with suicidal thoughts. METHOD: We assessed 93 schizophrenia patients. We matched subjects for age and sex and compared subjects with and without suicidal thoughts. We performed stepwise multiple regression analysis to assess the association between specific clinical symptoms and suicidal ideation. RESULTS: Of the patients, 20.4% reported suicidal thoughts during the last 15 days. Severity of depressive symptoms, motor retardation, guilt feelings, pathological guilt, and self-depreciation predicted the patients' suicidal ideation. CONCLUSIONS: Suicidal thoughts are frequent among inpatients with acute schizophrenia. Prevention of suicidal behaviour should include helping patients improve their self-esteem and reducing depression and guilt feelings.     

Implicit and explicit self-esteem as concurrent predictors of suicidal ideation, depressive symptoms, and loneliness

The aim of the present study was to examine whether explicit and implicit self-esteem, the interaction between these two constructs, and their discrepancy are associated with depressive symptoms, suicidal ideation, and loneliness. Participants were 95 young female adults (M = 21.2 years, SD = 1.88) enrolled in higher education. We administered the Name Letter Task to measure implicit self-esteem, and the Rosenberg self-esteem scale to assess explicit self-esteem. The results indicated that explicit but not implicit self-esteem was negatively associated with depressive symptoms, suicidal ideation, and loneliness. The interaction of implicit and explicit self-esteem was associated with suicidal ideation, indicating that participants with high implicit self-esteem combined with a low explicit self-esteem showed more suicidal ideation. Furthermore, the size of the discrepancy between implicit and explicit self-esteem was positively associated with depressive symptoms, suicidal ideation, and loneliness. In addition, results showed that the direction of the discrepancy is an important: damaged self-esteem (high implicit self-esteem combined with low explicit self-esteem) was consistently associated with increased levels of depressive symptoms, suicidal ideation, and loneliness, while defensive or fragile self-esteem (high explicit and low implicit self-esteem) was not. Together, these findings provide new insights into the relationship of implicit and explicit self-esteem with depressive symptoms, suicidal ideation, and loneliness.     

富马酸奎硫平与氟哌啶醇对精神分裂症抑郁症状影响的对照研究

目的:对照比较富马酸奎硫平与氟哌啶醇对精神分裂症患者抑郁症状的作用。方法:70例精神分裂症偏执型患者随机分为两组,分别予以富马酸奎硫平及氟哌啶醇治疗4周,于入组前、用药第1、14天及第28天以中文版卡尔加里精神分裂症抑郁量表(CDSS-C)、阳性和阴性症状量表(PANSS)及治疗中出现的症状量表(TESS)进行评定,并体格检查及实验室检查,记录不良事件的发生,以量表分值的变化来判断治疗效果及药物不良反应。结果:①70例患者中有21例患者CDSS-C评分≥6分,抑郁发生率为30%;②富马酸奎硫平组与氟哌啶醇组患者在抑郁症状疗效上差异有统计学意义(有效率分别为90.9%和37.5%,P=0.000),在精神病性症状改善方面无统计学差异(有效率分别为44.4%和54.9%,P=0.481);③氟哌啶醇组药物不良反应严重程度及不良反应所引起的痛苦均要明显高于奎硫平组,且对血泌乳素水平影响较大,多个研究时点TESS评分两组差异均有统计学意义(P=0.000～0.002)。结论:富马酸奎硫平相对于氟哌啶醇对精神分裂症的抑郁症状有较好的疗效和较小的不良反应。     

慢性精神分裂症患者认知功能与血清C-反应蛋白的关联研究

目的:探讨慢性精神分裂症患者血清C-反应蛋白(CRP)水平与神经认知功能的相关性。方法:检测50例符合《美国精神障碍诊断与统计手册》第4版精神分裂症诊断标准的女性患者(患者组)和50名健康志愿者(正常对照组)血清CRP水平;采用阳性与阴性症状量表(PANSS)评估患者的临床症状,威斯康星卡片分类测试(WCST)、连线测试(TMT)评估患者的认知功能;对CRP水平与临床症状及认知功能进行相关分析并与正常对照组进行比较。结果:患者组血清CRP水平明显高于正常对照组(t=9.203,P0.001);WCST、TMT测验成绩明显差于正常对照组(t=4.462~6.815,P均0.001)。患者组血清CRP水平与PANSS总分及阴性症状分呈正相关(r=0.422,r=0.372;P0.05);与WCST正确数、完成分类数呈负相关(r=-0.364,r=-0.375;P0.05),与WCST错误总数、持续错误数、随机错误数呈正相关(r=0.341,r=0.346,r=0.381;P均0.05);与TMT-A、TMT-B呈正相关(r=0.411,r=0.483;P均0.05)。结论:慢性期精神分裂症患者存在明显免疫异常,血清CRP水平与认知功能和阴性症状密切相关。     

Depression,aggression, and suicidal ideation in first graders: a school-based cross-sectional study

Objective

This study explored the clinical characteristics and risk factors of suicidal ideation in a sample of first graders from South Korea. Children's depression and aggression and maternal depression were examined as possible risk factors.

Methods

This study is a school-based, cross-sectional study of 5 elementary schools in Gunpo City, South Korea. Participants were 707 first graders (mean age, 6.54 years) and their mothers. We assessed children's depressive and aggressive symptoms using the Behavior Assessment System for Children-2 (BASC-2) and maternal depression using the Beck Depression Inventory (BDI). Two items from BASC-2 and 1 item from BDI identified children's and maternal suicidal ideation.

Results

Twenty-seven (3.8%) children evidenced suicidal ideation. Children with suicidal ideation had higher mean scores of depression domain (10.11 ± 5.34 vs 4.57 ± 3.44, P < .0001) and aggression domain (7.78 ± 3.84 vs 3.80 ± 2.85, P < .0001) on BASC-2 and maternal depression (9.78 ± 6.45 vs 7.28 ± 5.38, P = .02) on BDI. In regression analysis, children's depression (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.07-1.32; P = .001) and aggression (OR, 1.24; 95% CI, 1.08-1.41; P = .002) contributed significantly to children's suicidal ideation, whereas maternal depression was not significantly related to children's suicidal ideation (OR, 0.99; 95% CI, 0.92-1.06; P = .75).

Conclusions

This study demonstrated that even first graders had a considerable prevalence of suicidal ideation and that depression and aggression were associated with suicidal ideation in young children.     

Occurrence and course of suicidality during short-term treatment of late-life depression

BACKGROUND: Elderly persons (> or =65 years) have the highest rate of suicide; still, little is known about the occurrence, course, and responsivity of suicidal ideation during treatment of depression in late life and how suicidality affects treatment response. METHODS: This study was undertaken to determine (1) how suicidal ideation changes during short-term depression treatment and (2) whether treatment response differs among 3 groups of patients based on their levels of suicidality at baseline and during treatment (those with a recent suicide attempt or current suicidal ideation [high-risk group; n = 46], those with recurrent thoughts of death [moderate-risk group; n = 143], or those with no suicide attempt, suicidal ideation, or thoughts of death [low-risk group; n = 206]). This is a secondary analysis of pooled data from 3 treatment studies of late-life major depression. Participants were 395 elderly persons with a current major depressive episode, treated as inpatients or outpatients under protocolized conditions with paroxetine hydrochloride or nortriptyline hydrochloride, with or without interpersonal psychotherapy. Changes in suicidal ideation over time, rate of responses, and time to response in each group were compared. RESULTS: Suicidal ideation decreased rapidly early in the course of treatment, with more gradual change thereafter. At the beginning of treatment, 77.5% of the patients reported suicidal ideation, thoughts of death, or feelings that life is empty. After 12 weeks of treatment, suicidal ideation had resolved in all treated patients; 4.6% still reported thoughts of death. However, 6-week (P =.001) and 12-week (P =.02) rates of response were significantly lower in high-risk patients than in low- and moderate-risk patients. High- and moderate-risk patients needed a significantly (P<.001) longer time to respond than low-risk patients (median time to response, 6 and 5 vs 3 weeks). CONCLUSIONS: While suicidal ideation resolves rapidly, the resolution of thoughts about death is more gradual. Suicidal elderly persons with depression require special attention during depression treatment because they have a lower response rate and need a longer time to respond.     

家庭暴力与抑郁症患者自杀的相关研究

目的　研究家庭暴力与抑郁症自杀的关系。方法　采用自行设计的家庭暴力调查表、汉密尔顿抑郁量表、社会支持评定量表、艾森克人格问卷 (EPQ)和特质应对方式问卷 ,对 72例抑郁症患者 (有家庭暴力组 38例 ,无家庭暴力组 34例 )进行评定和比较 ;将自杀程度分为轻度 (偶尔有自杀想法 )、中度 (频繁有自杀想法 )和重度 (自杀未遂 )。结果　 ( 1)家庭暴力与频繁有自杀想法 [比值比(OR) =11.333,χ2 =9.5 2 8,P =0 .0 0 6 ]和自杀未遂 (OR =16 80 0 ,χ2 =11 386 ,P =0 0 0 1)存在关联 ,且OR值随自杀程度的升高而增大 ;不同性别比较 ,家庭暴力与女性频繁自杀想法和自杀未遂均存在关联 ( χ2 =8 2 2 4和 5 4 90 ,P <0 0 5 ) ,仅与男性自杀未遂存在关联 ( χ2 =6 4 2 9,P <0 0 5 )。 ( 2 )有家庭暴力组的总社会支持分 [( 35 32± 9 5 1)分 ]低于无家庭暴力组 [( 39 6 2± 6 74 )分 ,t=2 19,P <0 0 5 ];EPQ的神经质 (t=- 2 6 4 )、精神质 (t=- 2 10 )和消极应对评分 (t=- 2 5 6 )均高于无家庭暴力组 (均P <0 0 5 )。结论　家庭暴力与抑郁症患者自杀呈明显关联 ,且存在性别差异 ;患者的社会支持、个性和应对方式等社会心理因素对此关联有一定影响     

Thought suppression and suicidal ideation: preliminary evidence in support of a robust association

Background: The suppression of unwanted thoughts appears to contribute to the development and maintenance of emotional disorders. This report tested the thought suppression paradigm in relation to suicidal ideation. Based on the ironic process theory, we hypothesized that the suppression of unwanted thoughts, especially suicidal thoughts, would associate with a higher frequency and a greater intensity of suicidal ideation. Methods: Study 1 examined cross‐sectional associations between self‐reported thought suppression and the frequency of suicidal ideation in a nonclinical sample of 166 undergraduate students. Study 2 extended cross‐sectional findings in an inpatient sample of 71 suicidal adolescents. Study 3 examined prospective associations between suicidal thought suppression and increases in self‐reported suicidal ideation over a 4‐week period in a separate nonclinical sample of 118 undergraduate students. Results: Findings across studies support a robust association between thought suppression and suicidal ideation, even controlling for general depressive symptoms. Participants in Studies 1 and 2 who endorsed greater tendencies toward suppression of thoughts, especially suicidal thoughts (Study 2), displayed higher concurrent levels of suicidal ideation. Participants in Study 3 who endorsed greater baseline tendencies toward suppression of suicidal thoughts displayed an increase in the severity of suicidal ideation over time. Conclusions: Suppression of suicidal thoughts may represent 1 mechanism contributing to the persistence of suicidal ideation. Clinicians may wish to explore patients' reactions to suicidal ideation and consider acceptance‐oriented strategies among patients who attempt to control unwanted suicidal thoughts. Depression and Anxiety, 2009. © 2008 Wiley‐Liss, Inc.     

Depressive characteristics of adult psychiatric inpatients with a history of multiple versus one or no suicide attempts

Background: A growing body of research suggests that individuals with a history of multiple suicide attempts exhibit more severe psychopathology than individuals with only one or no previous suicide attempts. Given the strong link between diagnoses of major depression and suicide risk, our primary goal was to determine which specific depressive characteristics differentiate multiple attempters from patients with one or no previous attempts. Methods: Participants were 121 depressed adult psychiatric inpatients. Participants were administered diagnostic interviews to assess the course and characteristics of their depression history as well as measures of suicidal ideation, suicide attempts, depressive symptoms, hopelessness, and dysfunctional attitudes. Results: Patients with a history of multiple suicide attempts exhibited higher levels of suicidal ideation and depressive symptoms, but not hopelessness or dysfunctional attitudes, than the other two groups. In addition, multiple attempters reported an earlier age of major depression onset. Conclusions: The current results add to a growing body of research suggesting that multiple attempters may represent a distinct patient population. Depression and Anxiety, 2009. Published 2008 Wiley‐Liss, Inc.