Brief Assessment of Psychological Pain to Predict Suicidal Events at One Year in Depressed Patients

Abstract

Dear Editor,Self-reported psychological pain could be a transdiagnostic tool in psychiatry and is closely connected to suicide [1]. Shneidman [2] defined it as “psychache,” an acute state of intense psychological pain associated with feelings of guilt, anguish, fear, panic, loneliness, and helplessness, which is at the core of the suicidal process. Previous research in 2 cohorts of students at high risk of suicide showed baseline psychological pain and variations in psychological pain to be stronger predictors of suicidal ideation (SI) than depression or hopelessness during follow-up [3, 4]. However, a prospective study in 153 psychiatric inpatients showed that baseline psychological pain did not predict a future suicide attempt (SA) [5].Physical pain has also been implicated in acute suicidal behavior [6] and is related to psychological pain [1]. Olié et al. [7] developed the Psychological and Physical Pain Visual Analog Scale (PPP-VAS) to rapidly evaluate 6 dimensions of pain: current, mean and worst (during the last 15 days) psychological pain and physical pain. This scale was recently validated in patients with depression and in patients at risk of suicide [8].Our aim was to determine whether baseline psychological and physical pain, assessed with the PPP-VAS, may predict suicidal events (i.e., suicide death, SA, and hospitalization for SI) at 1 year of follow-up in depressed patients. We hypothesized that psychological but not physical pain would predict future suicidal…