Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università Rome, Italy.
Pharmacopsychiatry. 2023 Nov;56(6):219-226. doi: 10.1055/a-2154-0828. Epub 2023 Sep 12.
Suicide is a leading cause of death worldwide and models may help the understanding of the phenomenon and ultimately reduce its burden through effective suicide prevention strategies. The Interpersonal Theory of Suicide and Shneidman's Model have tried to describe different unmet needs related to suicidal ideation. The study aims to assess the association between thwarted belongingness, perceived burdensomeness, and suicidal ideation in a sample of psychiatric inpatients and the mediating role of hopelessness and mental pain in this association.
112 consecutive adult psychiatric inpatients were administered the Columbia Suicide Severity Rating Scale (C-SSRS), the Italian version of the Interpersonal Needs Questionnaire-15-I (INQ-15-I), the Physical and Psychological Pain Scale, and the Beck Hopelessness Scale (BHS).
Mediation models indicated a significant indirect effect of perceived burdensomeness (with thwarted belongingness as covariates) on suicidal ideation intensity with hopelessness as a mediator. When thwarted belongingness (controlling for perceived burdensomeness as a covariate) was included in a model as an independent variable, direct and indirect effects on suicidal ideation intensity were not significant.
Psychosocial interventions focusing on identifying and decreasing the perception of being a burden for others and the feeling hopeless could represent a powerful pathway for reducing suicidal ideation. Moreover, the attention toward unmet interpersonal needs may help increase and focus clinical discussions on risk factors, which may help engagement toward psychiatric care and downsize the stigma related to suicide. Raising awareness toward mental health topics is a goal of healthcare services globally.
自杀是全球主要的死亡原因之一,而模型可以帮助我们理解这一现象,并通过有效的自杀预防策略来减轻其负担。人际理论和 Shneidman 模型试图描述与自杀意念相关的不同未满足的需求。本研究旨在评估在一组精神科住院患者中,受挫归属感、感知负担与自杀意念之间的关联,以及无望感和精神痛苦在这种关联中的中介作用。
对 112 名连续的成年精神科住院患者进行了哥伦比亚自杀严重程度评定量表(C-SSRS)、意大利版人际需求问卷-15-I(INQ-15-I)、身心疼痛量表和贝克无望感量表(BHS)的评估。
中介模型表明,感知负担(将受挫归属感作为协变量)对自杀意念强度具有显著的间接影响,无望感是其中介。当将受挫归属感(将感知负担作为协变量进行控制)作为自变量纳入模型时,其对自杀意念强度的直接和间接影响均不显著。
以识别和减少对他人的负担感和无望感为重点的心理社会干预措施可能是降低自杀意念的有效途径。此外,关注未满足的人际需求可能有助于增加和集中讨论风险因素,从而有助于患者接受精神科治疗,并减轻与自杀相关的耻辱感。提高对精神健康问题的认识是全球医疗保健服务的目标之一。