Suicide ideation versus suicide attempt: Examining overlapping and differential determinants in a large cohort of patients with depression and/or anxiety

Abstract

Objective: Individuals with a depressive and/or anxiety disorder are known to have an elevated risk of suicide. However, these diagnoses alone are insufficient at differentiating patients with suicide ideation that attempt suicide from those that do not. Few studies examined such differences in an ideation-to-action framework. Using this framework, extensive multivariate testing was performed to examine differences between suicidal patients with and without a suicide attempt. Method: Data were from 1576 respondents with a depressive and/or anxiety disorder, participating in the Netherlands Study of Depression and Anxiety. Logistic regression analyses were used to analyze associations between sociodemographic, clinical, personality, and psychosocial risk factors and suicide ideation and attempt. Results: Patients with suicide ideation could be uniquely distinguished from non-suicidal patients by more years of education, presence of a depressive disorder (vs anxiety disorder) and higher introversion. Patients with suicide ideation and a past suicide attempt could be uniquely distinguished from non-suicidal patients by a younger age of onset, a lifetime alcohol use disorder, more external locus of control and lower levels of social support. Within the group of patients with suicide ideation, patients with a suicide attempt were more likely to have childhood trauma and lower education, and be of non-Western descent than patients with suicide ideation and no past attempt. Conclusion: This study found that although various clinical, personality and psychosocial characteristics distinguish patients with suicide ideation from non-suicidal patients, many of these often-cited factors do not distinguish patients with a suicide attempt from those who only think about suicide. However, childhood trauma, lower education and non-Western descent could aid in detecting suicide attempt risk among patients with suicide ideation.

Sleep Duration Is Closely Associated with Suicidal Ideation and Suicide Attempt in Korean Adults: A Nationwide Cross-Sectional Study

“…Previous studies have reported that there are factors distinguishing those with suicide attempts from those who have experienced suicidal ideation but never attempted suicide. A markedly high presence of depressive disorder or hopelessness was seen in suicide ideators, and suicide attempters could be distinguished by a higher prevalence of comorbid substance use disorder, a younger age of onset, and a lack of social support [ 31 , 32 ]. The capability to attempt suicide caused progression from ideation to attempts [ 3 ].…”

Cognitive networks identify dimensions of distress in suicide notes: Anxiety, emotional profiles, and "words not said"

“…High-anxiety individuals may have an external locus of control (i.e., feeling one's life is controlled by external factors); perceived lack of control may facilitate feelings of hopelessness that, in theory, exacerbate suicidal ideation (Joiner, 2005). Indeed, having an external locus of control has been associated with suicide attempts (Wiebenga et al, 2021). It is also possible that 'high anxiety' is a proxy for overarousal and/or sensitivity to the experience of anxiety, both of which have been suggested as risk factors for suicide (Ribeiro et al, 2015;Stanley et al, 2018).…”

Sleep and Mental Health Issues in Current and Former Athletes: A Mini Review

“…Mental health issues are often co-morbid with other disorders. Suicide ideation is predicted by sleep problems, insomnia, depression, and anxiety ( Khader et al, 2020 ; Wiebenga et al, 2021 ). Worryingly, the association with sleep problems and suicide ideation is stronger amongst college athletes than non-athletes ( Wiebenga et al, 2021 ).…”

“…Suicide ideation is predicted by sleep problems, insomnia, depression, and anxiety ( Khader et al, 2020 ; Wiebenga et al, 2021 ). Worryingly, the association with sleep problems and suicide ideation is stronger amongst college athletes than non-athletes ( Wiebenga et al, 2021 ). Thus, it is unsurprising that 15.6% of collegiate athletes report suicide ideation, with some unfortunately, attempting and committing suicide ( Rao and Hong, 2016 ; Timpka et al, 2021 ; Wiebenga et al, 2021 ).…”