The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index.
Mental Pain and Suicide: A Systematic Review of the Literature
Open accessAbstract
BACKGROUND: Mental pain, defined as a subjective experience characterized by perception of strong negative feelings and changes in the self and its function, is no less real than other types of grief. Mental pain has been considered to be a distinct entity from depression. We have performed a systematic review analyzing the relationship between mental pain and suicide by providing a qualitative data synthesis of the studies. METHODS: We have conducted, in accordance with PRISMA guidelines, a systematic search for the literature in PubMed, Web Of Science, and Scopus. Search terms were "mental pain" "OR" "psychological pain" OR "psychache" combined with the Boolean "AND" operator with "suicid*." In addition, a manual search of the literature, only including the term "psychache," was performed on Google Scholar for further studies not yet identified. RESULTS: Initial search identified 1450 citations. A total of 42 research reports met the predefined inclusion criteria and were analyzed. Mental pain was found to be a significant predictive factor of suicide risk, even in the absence of a diagnosed mental disorder. Specifically, mental pain is a stronger factor of vulnerability of suicidal ideation than depression. CONCLUSION: Mental pain is a core clinical factor for understanding suicide, both in the context of mood disorders and independently from depression. Health care professionals need to be aware of the higher suicidal risk in patients reporting mental pain. In this regard, psychological assessment should include a clinimetric evaluation of mental pain in order to further detect its contribution to suicidal tendency.
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“Regardless of which risk factors are present, for many individuals who consider suicide, it is a response to physical or psychological pain and distress, accompanied with an unmet need to escape (Williams, 2014; Calati et al., 2015; Verrocchio et al., 2016).”
From The Psychological Pathway to Suicide Attempts: A Strategy of Control Without Awareness (2021) · cites this paper as Verrocchio et al., 2016
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“Experiencing intolerable levels of psychological pain has been associated with increased suicide risk [12] in both clinical and non-clinical populations [13].”
From Targeting Psychological Pain After a Suicide Attempt: Scoping Review and Intervention Protocol (2026) · cites this paper as [13]
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“Moreover, psychological pain is associated with suicidality, independently of underlying mental disorders.13,14”
From “Nothing Hurts Less Than Being Dead”: Psychological Pain in Case Descriptions of Psychiatric Euthanasia and Assisted Suicide from the Netherlands: « Rien ne fait moins mal qu’être mort »: La douleur psychologique dans les descriptions de cas d’euthanasie et de suicide assisté psychiatrique aux Pays-Bas (2020) · cites this paper as [14]
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Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.005 · Cited by 19,575
Commentary: Suicide as Psychache
SHNEIDMAN, E. S. (1993) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199303000-00001 · Cited by 775
Development and preliminary validation of a scale of psychache
Holden, R. R., Mehta, K., Cunningham, E. J., & McLeod, L. D. (2001) · Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement · doi:10.1037/h0087144 · Cited by 354
An evaluation of crisis hotline outcomes. Part 2: Suicidal callers
Gould, M. S., Kalafat, J., HarrisMunfakh, J. L., & Kleinman, M. (2007) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2007.37.3.338 · Cited by 278
Mental Pain: A Multidimensional Operationalization and Definition
Orbach, I., Mikulincer, M., Sirota, P., & Gilboa‐Schechtman, E. (2003) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.33.3.219.23219 · Cited by 257
Bech, P. (2012) · doi:10.1002/9781118511800 · Cited by 243
Self-citationClinimetrics: the science of clinical measurements
Fava, G. A., Tomba, E., & Sonino, N. (2012) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2011.02825.x · Cited by 233
Mental Pain and Its Relationship to Suicidality and Life Meaning
Orbach, I., Mikulincer, M., Gilboa‐Schechtman, E., & Sirota, P. (2003) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.33.3.231.23213 · Cited by 215
Troister, T., & Holden, R. R. (2010) · Personality and Individual Differences · doi:10.1016/j.paid.2010.06.006 · Cited by 175
Olié, E., Guillaume, S., Jaussent, I., Courtet, P., & Jollant, F. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.03.013 · Cited by 174
An fMRI study on mental pain and suicidal behavior
Reisch, T., Seifritz, E., Esposito, F., Wiest, R., Valach, L., & Michel, K. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.03.005 · Cited by 173
Further Reflections on Suicide and Psychache
Shneidman, E. S. (1998) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.1998.tb00854.x · Cited by 164
Perspectives on suicidology. Further reflections on suicide and psychache.
Shneidman, E. S. (1998) · PubMed · Cited by 145
Tossani, E. (2013) · Psychotherapy and Psychosomatics · doi:10.1159/000343003 · Cited by 137
Mental pain and its communication in medically serious suicide attempts: an “impossible situation”
Levi, Y., Horesh, N., Fischel, T., Treves, I., Or, E., & Apter, A. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.02.022 · Cited by 125
Assessment of psychological pain in major depressive episodes
Mee, S., Bunney, B. G., Bunney, W. E., Hetrick, W. P., Potkin, S. G., & Reist, C. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.06.011 · Cited by 122
Psychache and Suicide Ideation among Men Who Are Homeless: A Test of Shneidman’s Model
Patterson, A. A., & Holden, R. R. (2012) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2011.00078.x · Cited by 114
Impulsive Choice and Psychological Pain in Acutely Suicidal Depressed Patients
Cáceda, R., Durand, D., Cortes, E., Prendes-Alvarez, S., Moskovciak, T., Harvey, P. D., & Nemeroff, C. B. (2014) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000075 · Cited by 113
The functional neuroanatomy of mental pain in depression
van Heeringen, K., Van den Abbeele, D., Vervaet, M., Soenen, L., & Audenaert, K. (2010) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2009.07.011 · Cited by 113 · cited 3×
“In other terms, the results indicate that levels of mental pain are associated with an increased risk of suicide, independently from the severity of depressive condition (25).”
BackgroundTroister, T., & Holden, R. R. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.21869 · Cited by 106
An Evaluation of the Psychache Scale on an Offender Population
Mills, J. F., Green, K., & Reddon, J. R. (2005) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2005.35.5.570 · Cited by 102
Li, H., Xie, W., Luo, X., Fu, R., Shi, C., Ying, X., Wang, N., Yin, Q., & Wang, X. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12056 · Cited by 101
Differentiating Between Depression, Hopelessness, and Psychache in University Undergraduates
DeLisle, M. M., & Holden, R. R. (2009) · Measurement and Evaluation in Counseling and Development · doi:10.1177/0748175609333562 · Cited by 100
Psychache as a mediator in the relationship between perfectionism and suicidality.
Flamenbaum, R., & Holden, R. R. (2007) · Journal of Counseling Psychology · doi:10.1037/0022-0167.54.1.51 · Cited by 93
Xie, W., Li, H., Luo, X., Fu, R., Ying, X., Wang, N., Yin, Q.-F., Zou, Y.-M., Cui, Y., Wang, X., et al. (2013) · Journal of Clinical Psychology · doi:10.1002/jclp.22055 · Cited by 89
Horesh, N., Levi, Y., & Apter, A. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.11.035 · Cited by 88
A psychological approach to suicide.
Shneidman, E. S. (1987) · American Psychological Association eBooks · doi:10.1037/11106-004 · Cited by 88
Gvion, Y., Horresh, N., Levi-Belz, Y., Fischel, T., Treves, I., Weiser, M., David, H. S., Stein-Reizer, O., & Apter, A. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.09.003 · Cited by 87
Levi‐Belz, Y., Gvion, Y., Horesh, N., & Apter, A. (2013) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12035 · Cited by 83
Troister, T., & Holden, R. R. (2012) · Measurement and Evaluation in Counseling and Development · doi:10.1177/0748175612451744 · Cited by 83
Barak, A., & Miron, O. (2005) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2005.35.5.507 · Cited by 82
Levi‐Belz, Y., Gvion, Y., Horesh, N., Fischel, T., Treves, I., Or, E., Stein-Reisner, O., Weiser, M., David, H. S., & Apter, A. S. (2013) · Archives of Suicide Research · doi:10.1080/13811118.2013.809041 · Cited by 77
Psychache and Suicidality in Adult Mood Disordered Outpatients in Brazil
Berlim, M. T., Mattevi, B. S., Pavanello, D. P., Caldieraro, M. A., Fleck, M. P., Wingate, L. R., & Joiner, T. E. (2003) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.33.3.242.23220 · Cited by 74
Troister, T., Davis, M. P., Lowndes, A., & Holden, R. R. (2013) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12043 · Cited by 73
Psychache and suicide: a preliminary investigation
Pompili, M., Lester, D., Leenaars, A. A., Tatarelli, R., & Girardi, P. (2008) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2008.38.1.116 · Cited by 65
The Challenge and the Promise of Clinical Suicidology
Jobes, D. A. (1995) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.1995.tb00237.x · Cited by 64
Campos, R. C., & Holden, R. R. (2015) · Journal of Clinical Psychology · doi:10.1002/jclp.22196 · Cited by 57
Testing Shneidman’s model of suicidality in incarcerated offenders and in undergraduates
Pereira, E. J., Kroner, D. G., Holden, R. R., & Flamenbaum, R. (2010) · Personality and Individual Differences · doi:10.1016/j.paid.2010.07.029 · Cited by 56
A proposed model of the development of suicidal ideations
Gvion, Y., Horesh, N., Levi‐Belz, Y., & Apter, A. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2014.09.019 · Cited by 51
The Importance of Mental Pain and Physical Dissociation in Youth Suicidality
Levinger, S., Somer, E., & Holden, R. R. (2015) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2014.989644 · Cited by 50
You, Z., Song, J., Wu, C., Qin, P., & Zhou, Z. (2014) · BMJ Open · doi:10.1136/bmjopen-2013-004096 · Cited by 48
Soumani, A., Δαμίγος, Δ., Oulis, P., Masdrakis, V. G., Ploumpidis, D., Mavreas, V. G., & Konstantakopoulos, G. (2011) · PubMed · Cited by 47
From the Serotonin Model of Suicide to a Mental Pain Model of Suicide
de León, J., Baca‐García, E., & Blasco-Fontecilla, H. (2015) · Psychotherapy and Psychosomatics · doi:10.1159/000438510 · Cited by 44
Campos, R. C., Holden, R. R., Laranjeira, P., Troister, T., Oliveira, A. R., Costa, F., Abreu, M., & Fresca, N. (2016) · Death Studies · doi:10.1080/07481187.2016.1150920 · Cited by 41
May, A. M., O’Brien, K. H. M., Liu, R. T., & Klonsky, E. D. (2016) · Archives of Suicide Research · doi:10.1080/13811118.2015.1095688 · Cited by 39
Emotional Regulation of Mental Pain as Moderator of Suicidal Ideation in Military Settings
Shelef, L., Fruchter, E., Hassidim, A., & Zalsman, G. (2015) · European Psychiatry · doi:10.1016/j.eurpsy.2014.12.004 · Cited by 38
Trakhtenbrot, R., Gvion, Y., Levi-Belz, Y., Horesh, N., Fischel, T., Weiser, M., Treves, I., & Apter, A. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.03.054 · Cited by 37
Sources of Psychological Pain and Suicidal Thoughts Among Homeless Adults
Coohey, C., Easton, S. D., Kong, J., & Bockenstedt, J. K. W. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12126 · Cited by 30
A Note on Shneidman's Psychological Pain Assessment Scale
Leenaars, A. A., & Lester, D. (2005) · OMEGA - Journal of Death and Dying · doi:10.2190/wh9x-80m3-nj54-5gcu · Cited by 26
Does suicidal desire moderate the association between frontal delta power and psychological pain?
Meerwijk, E. L., & Weiss, S. J. (2016) · PeerJ · doi:10.7717/peerj.1538 · Cited by 24
Mental pain as a mediator of suicidal tendency: A path analysis
Nahaliel, S., Sommerfeld, E., Orbach, I., Weller, A., Apter, A. S., & Zalsman, G. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.12.014 · Cited by 23
Psychache, Depression, and Personality
Lester, D. (2000) · Psychological Reports · doi:10.2466/pr0.2000.87.3.940 · Cited by 22
Hopelessness and Suicidal Behavior: An Overview
Beck, A. T. (1975) · JAMA · doi:10.1001/jama.1975.03260240050026 · Cited by 11
PSYCHACHE, DEPRESSION, AND PERSONALITY
Lester, D. (2000) · Psychological Reports · doi:10.2466/pr0.87.7.940-940 · Cited by 10
Leenaars, A. A., Lester, D., & Wenckstern, S. (1999) · Psychological Reports · doi:10.2466/pr0.1999.85.2.363 · Cited by 8
Levinger, S., & Holden, R. R. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12087 · Cited by 7
Flagged first, then by citations
Research works printed but not linked: 3
- W.H.O., 2014, Preventing Suicide: A Global Imperative
- Buchwald, 2006, Too Soon to Say Goodbye
- DeLisle, 2004, Depression, hopelessness, and psychache as increasingly specific predictors of suicidal manifestations, Can Clin Psychol, 15, 7
Cited by
Sorted by citations
Suicide in older adults: current perspectives
Conejero, I., Olié, É., Courtet, P., & Calati, R. (2018) · Clinical Interventions in Aging · doi:10.2147/cia.s130670 · Cited by 446
Psychological pain, depression, and suicide: Recent evidences and future directions
Conejero, I., Olié, E., Calati, R., Ducasse, D., & Courtet, P. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0893-z · Cited by 206
Chevance, A., Ravaud, P., Tomlinson, A., Le Berre, C., Teufer, B., Touboul, S., Fried, E. I., Gartlehner, G., Cipriani, A., & Tran, V. T. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30191-7 · Cited by 193
Allen, N. B., Nelson, B. W., Brent, D., & Auerbach, R. P. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.03.044 · Cited by 115
Cheek, S. M., Reiter-Lavery, T., & Goldston, D. B. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101936 · Cited by 83
Metadata
- Authors
- Verrocchio, M. C., Carrozzino, D., Marchetti, D., Andreasson, K., Fulcheri, M., & Bech, P.
- Affiliations
- University of Chieti-Pescara (IT)
- Copenhagen University Hospital (DK)
- Corresponding author
- Verrocchio, Maria Cristina
- ORCID
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2016-06-20
- Volume
- 7
- Pages
- 108-108
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC4913233
- OpenAlex
- W2471867149
- Cited by
- 297
- References
- 57
- Citations by year
- 2026: 19 · 2025: 46 · 2024: 26 · 2023: 26 · 2022: 27 · 2021: 30 · 2020: 28 · 2019: 27 · 2018: 41 · 2017: 19 · 2016: 6
- FWCI
- 4.60
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- psychological suffering, emotional pain, suicide, suicidal ideation, suicide risk, depression, mood disorders, psychological assessment
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