The role of impulsivity in suicide attempts among patients with major depressive disorder: A cross-sectional study.

BACKGROUND

Suicide is a major global public health concern, particularly among individuals with major depressive disorder (MDD). While depression is a well-known risk factor, not all patients with MDD attempt suicide, indicating the need to explore additional contributors such as impulsivity.

AIM: To assess the role of impulsivity in suicidal behavior among patients with MDD, comparing those with and without a history of suicide attempts.

MATERIALS AND

METHODS

This cross-sectional study included 150 patients diagnosed with MDD at a tertiary care center, divided into two groups: those with (n = 73) and without (n = 77) suicide attempts. Psychiatric assessments included the Hamilton Depression Rating Scale (HAM-D), Suicide Behavior Questionnaire-Revised (SBQ-R), and Barratt Impulsiveness Scale-11 (BIS-11), which evaluates three domains of impulsivity: attentional, motor, and non-planning. Statistical analyses included Mann-Whitney U tests, Spearman's rank correlations, and Pearson's correlations.

RESULTS

Patients with suicide attempts had significantly higher SBQ-R (mean = 12.38) and BIS-11 scores (mean = 85.03) compared to non-attempters (SBQ-R mean = 8.22; BIS-11 mean = 61.34; P < 0.001). No significant difference was found in depression severity (HAM-D scores). Among attempters, suicidality was strongly correlated with impulsivity (ρ = 0.423, P < 0.001) and moderately with depression (ρ = 0.336, P = 0.004). Attentional (r = 0.42, P = 0.001) and motor impulsivity (r = 0.31, P = 0.015) were significantly associated with suicide risk.

CONCLUSION

Impulsivity, particularly attentional and motor domains, is a significant independent predictor of suicide attempts in patients with MDD, beyond depression severity. Incorporating impulsivity assessment into routine psychiatric evaluations may enhance suicide risk prediction and inform targeted interventions.