Global and reflective rumination are related to suicide attempts among patients experiencing major depressive episodes

Abstract

Background Recent attention has focused on the role of rumination in suicidality, with evidence indicating that rumination may be positively related to suicidal ideation. There remains disagreement on the nature of the relationship between rumination and suicide attempts, especially in major affective disorders. This study was designed to identify whether rumination is a risk factor for attempted suicide. Methods A total of 309 patients with major depressive episodes were recruited for this study, including 170 patients with major depression and 139 patients with bipolar disorder. All participants were categorized into two groups based on a series of clinical assessments: suicide attempters (n = 87) and non-suicide attempters (n = 222). Rumination was evaluated with the Ruminative Responses Scale. A binary logistic regression analysis was carried out to evaluate the relationship between rumination and suicide attempts. Results Both global ruminative levels and the two subtypes of rumination, brooding and reflection, were significantly higher in the suicide attempters than the non-suicide attempters. After controlling for age, current depression and anxiety symptoms, and episode frequency, it was found that global rumination and reflection (but not brooding) were positively associated with suicide attempts. Conclusion These results suggest that rumination may be a risk factor for suicide attempts and highlight the maladaptive nature of reflection in patients with major depressive episodes.

The Relationship between Depressive Symptoms, Rumination, and Suicide Ideation in Patients with Depression

“…In this study, there was a positive correlation between rumination and suicidal ideation, indicating that a higher rumination score on admission may signify more serious suicidal ideation. A previous study found that correlations between depression symptoms and rumination and between suicidal thoughts that persisted over a long period and rumination were similar [ 14 ]. Depressive symptoms and rumination can both predict suicidal ideation.…”

“…Treynor et al divided rumination into (1) reflection (facing and solving problems and difficulties), and (2) brooding (discouraged and frustrated). The brooding style and reflection style of rumination had an impact on suicide attempts [ 14 ]. Rumination can predict suicide [ 15 ].…”

Daily Levels and Dynamic Metrics of Affective–Cognitive Constructs Associate With Suicidal Thoughts and Behaviours in Adults After Psychiatric Hospitalization

“…These studies provided information about how trait-levels of ACCs relate to STBs and how these relations change across long timescales often spanning months or years, offering insight into which individuals are at overall elevated risk for STBs (Franklin et al 2017;Turecki and Brent 2016). In general, higher positive affect (e.g., Han et al 2022) associates with lower STB risk, while higher negative affect (e.g., Yamokoski, Scheel, and Rogers 2011), rumination (e.g., Tang et al 2021), distress intolerance (e.g., Slabbert et al 2022) and emotion dysregulation (e.g., Wallace et al 2023) associate with elevated STB risk in cross-sectional and panel studies.…”

Ruminative Thinking in Chronic Depression: Concept and Validity of Measures

“…Клинические исследования говорят о том, что руминации «мрачно-задумчивого» типа в бóльшей степени связаны с риском хронификации депрессии и суицидальным риском [29; 33], в то время как рефлексивные (более активные) руминации способствуют уменьшению депрессии с течением времени [38]. При этом в одном из последних исследований показан противоположный результат: именно рефлексивные руминации при контроле социодемографических и клинических факторов выступили предиктором суицидального риска [39].…”