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Cited by 42Suicide and Self-Harm StudiesPersonality Disorders and PsychopathologyHomicide, Infanticide, and Child Abuse

Prevalence and correlates of lifetime deliberate self-harm and suicidal ideation in naturalistic outpatients: The Leiden Routine Outcome Monitoring study

de Klerk, Suzanne, van Noorden, Martijn S., van Giezen, Anne E., Spinhoven, Philip, den Hollander-Gijsman, Margien E., Giltay, Erik J., Speckens, Anne E.M., Zitman, Frans G.·2011·Journal of Affective Disorders
DOI 10.1016/j.jad.2011.03.021
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Abstract

Background Deliberate self-harm and suicidal ideation (DSHI) are common phenomena in general and mental health populations. Identifying factors associated with DSHI may contribute to the early identification, prevention and treatment of DSHI. Aims of the study are to determine the prevalence and correlates of lifetime DSHI in a naturalistic sample of psychiatric outpatients with mood, anxiety or somatoform (MAS) disorders. Methods Of 3798 consecutive patients from January 2004 to December 2006, 2844 (74.9%) patients were analyzed (mean age=37.5, SD=12.0; age range: 18-65; 62.7% women). Lifetime DSHI was assessed with routine outcome monitoring (ROM), including demographic parameters, DSM-IV diagnosis, depressive symptoms, symptoms of anxiety, general psychopathology and personality traits. Results Of the 2844 subjects, 55% reported lifetime DSHI. In multivariable logistic regression analysis, the most important factors associated with lifetime DSHI were being unmarried, low education, high number of psychiatric diagnoses, lower anxiety scores, higher depression scores and the personality trait of emotional dysregulation. Limitations Deliberate self-harm may have been under-reported in self-report questionnaires; The assessment of personality traits may have been influenced by state psychopathology; traumatic events were not assessed. Conclusions The findings suggest that DSHI is common among psychiatric outpatients with MAS disorders and that current symptoms and underlying personality vulnerabilities were independently involved in DSHI. Whether symptoms of somatic anxiety are protective should be confirmed in subsequent studies. These findings may help clinicians in identifying patients at risk for deliberate self-harm and suicide.

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  • This finding is inconsistent with the belief that suicidal individuals have a greater amount of negative emotions.

    “This is inconsistent with the belief that suicidal individuals have a greater amount of negative emotions (de Klerk et al., 2011; Orbach, Mikulincer, Gilboa-Schechtman, & Sirota, 2003; Stein, Apter, Ratzoni, Har-Even, & Avidan, 1998), and some research has previously shown that “negative emotion [words] use tends to increase approaching suicide” (Pennebaker & Chung, 2013).”

    From In an Absolute State: Elevated Use of Absolutist Words Is a Marker Specific to Anxiety, Depression, and Suicidal Ideation (2018) · cites this paper as de Klerk et al., 2011

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Authors
de Klerk, S., van Noorden, M. S., van Giezen, A. E., Spinhoven, P., den Hollander-Gijsman, M. E., Giltay, E. J., Speckens, A. E. M., & Zitman, F. G.
Affiliations
  • Leiden University (NL)
  • Leiden University Medical Center (NL)
  • Radboud University Nijmegen (NL)
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2011-09
Volume
133
Issue
1-2
Pages
257-264
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2011.03.021
OpenAlex
W2122319569
Cited by
42
References
71
Citations by year
2025: 1 · 2024: 2 · 2023: 5 · 2022: 1 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 3 · 2013: 8 · 2012: 2
FWCI
4.49
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
self-harm, suicidal ideation, mood disorders, anxiety disorders, somatoform disorders, psychiatric outpatients, prevalence, risk factors, emotional dysregulation, personality traits, depression, anxiety, marital status, educational attainment, comorbidities, suicide prevention
MeSH terms
Suicide Prevention, Adolescent, Adult, Aged, Anxiety Disorders, Mental Disorders, Depression, Depressive Disorder, Emotions, Female, Humans, Male, Middle Aged, Netherlands, Outpatients, Surveys and Questionnaires, Risk Factors, Suicide, Suicide, Attempted, Prevalence, Self-Injurious Behavior, Outcome Assessment, Health Care, Diagnostic and Statistical Manual of Mental Disorders, Suicidal Ideation

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