Differentiating suicide attempters from suicidal ideators: Differences between major depressive and bipolar disorders.

BACKGROUND

Studies have emphasized the importance of identifying psychological variables that differentiate individuals who have engaged in suicide attempts from those who had suicidal ideations that did not progress to attempts.

OBJECTIVES

This study aimed to investigate the differences between individuals with major depressive disorder (MDD) and bipolar disorder (BD) in the progression from suicidal ideations to suicide attempts, using the ideation-to-action framework.

METHODS

Participants were outpatients who visited the Mood Disorder and Suicide Prevention Clinic at Asan Medical Center, South Korea. Suicidal history, early maladaptive schemas, borderline personality features, childhood maltreatment, and interpersonal-psychological theory of suicide factors were assessed using self-report questionnaires. Independent t-tests and multivariable logistic regression examined factors differentiating patients with MDD and BD who experienced suicidal ideations (SIs) and those with suicide attempt histories (SAs).

RESULTS

In the MDD group, differentiating factors included specific maladaptive schemas, self-harming behavior, childhood emotional abuse, perceived burdensomeness, and fearlessness about death. In the BD group, differentiating factors included multiple early maladaptive schemas, borderline personality features, childhood physical and sexual abuse, and perceived burdensomeness.

CONCLUSIONS

This study revealed different factors distinguishing between SIs and SAs in those with MDD versus BD, suggesting the importance of considering diagnostic differences within the ideation-to-action framework. Future research should prospectively evaluate the predictive validity of these differentiating factors in assessing suicide risk.