Trait Anxiety Mediates Impulsivity and Suicidal Ideation in Depression During COVID-19 Pandemic

Abstract

Suicidality in patients with major depressive disorder (MDD) has been an urgent affair during the COVID-19 pandemic. It is well-established that impulsivity and trait anxiety are two risk factors for suicidal ideation. However, literature is still insufficient on the relationships among impulsivity, (state/trait) anxiety and suicidal ideation in individuals with MDD. The present study aims to explore the relationships of these three variables in MDD patients during the COVID-19 pandemic through three scales, including Barrett Impulsivity Scale (BIS), State-Trait Anxiety Scale (STAI) and Self-rating Idea of Suicide Scale (SIOSS). Sixty-three MDD patients (low SIOSS group and high SIOSS group, which were split by the mean score of SIOSS) and twenty-seven well-matched healthy controls were analyzed. Our results showed that the high SIOSS group had higher trait anxiety (p < 0.001, 95% CI = [−19.29, −5.02]) but there was no difference in state anxiety (p = 0.171, 95% CI = [−10.60, 1.25]), compared with the low SIOSS group. And the correlation between impulsivity and suicidal ideation was significant in MDD patients (r = 0.389, p = 0.002), yet it was not significant in healthy controls (r = 0.285, p = 0.167). Further, mediation analysis showed that trait anxiety significantly mediate impulsivity and suicidal ideation in patients with depression (total effect: β = 0.304, p = 0.002, 95% CI = [0.120, 0.489]; direct effect: β = 0.154, p = 0.076, 95% CI = [−0.169, 0.325]), indicating impulsivity influenced suicidal ideation through trait anxiety in MDD patients. In conclusion, our results suggested that trait anxiety might mediate the association of impulsivity and suicidal ideation in MDD patients. Clinicians may use symptoms of trait anxiety and impulsivity for screening when actively evaluating suicidal ideation in MDD patients, especially in the setting of COVID-19 pandemic.

Influence of Loneliness, Anxiety, and Depression on Suicidal Ideation in Peruvian Adults during the COVID-19 Pandemic

“…This first finding is consistent with those obtained from other studies, for example, that mood disorders are highly associated with suicide, especially in patients with major depression [1][2][3][4]42]. Our data agree with findings where the presence of clinically significant depression is related to the presence of suicidal ideation [5], and that depressive symptoms increase the likelihood of reflecting suicidal ideation [22][23][24]. Our data also coincide with those found in depressive patients in France, with high levels of anxiety, insomnia, suicidal ideation, and traumatic stress [21].…”

“…In France, loneliness and boredom were independent predictors of depression, anxiety and insomnia in vulnerable people, whereas daily physical activity was a protective factor; virtual contacts also protected against suicidal ideation [21]. In Shanghai, during the COVID-19 pandemic, it was found that, in patients with major depressive disorder, trait anxiety could significantly mediate the relationship between impulsivity and suicidal ideation [22].…”

Time-course changes in mental distress and their predictors in response to the coronavirus disease 2019 (COVID-19) pandemic: A longitudinal multi-site study of hospital staff

“…Students who showed higher trait anxiety were found to express more negative emotions and to perceive themselves as having less academic self-efficacy [ 38 ]. Patients with major depression who exhibited stronger suicidal ideation were reported to have higher impulsivity and trait anxiety [ 39 ]. The present longitudinal study further suggests the potential of trait anxiety as an easily evaluated predictor of the trajectory of psychological distress in response to stressors.…”

The Relationships Between Suicidal Ideation, Meaning in Life, and Affect: a Network Analysis

“…The SIOSS is a self-rating scale evaluating suicide ideation (Cheng et al, 2022 ; Xia et al, 2012 ). It comprises 26 items divided into 4 dimensions: optimism, sleep, despair, and concealment.…”