title: Higher psychological pain during a major depressive episode may be a factor of vulnerability to suicidal ideation and act.
abstract: BACKGROUND
  It has been suggested that psychological pain ("psychache") is a key factor in the suicidal process. In addition, suicidal acts may be best understood within a stress-vulnerability model. We hypothesized that more intense psychache during a major depressive episode would be a factor of vulnerability to suicidal behavior.
  
  
  METHODS
  Patients hospitalized for a major depressive episode, including 87 individuals with a recent history of suicidal acts, 61 individuals with a past history of suicidal acts, and 62 individuals without any suicidal history, were assessed at admission using several Visual Analog scales to measure levels of psychache, physical pain and suicidal ideation.
  
  
  RESULTS
  Patients with a recent or past history of suicide attempts expressed significantly higher levels of current psychological pain, and a higher intensity and frequency of current suicidal ideation than patients without any history of suicidal acts. The level of current psychache was significantly and positively associated with intensity and frequency of suicidal ideation. There were no between-group differences for physical pain.
  
  
  CONCLUSIONS
  Medication status was not controlled. A lack of statistical power may have masked an association between physical pain and suicidal ideation.
  
  
  CONCLUSIONS
  Higher psychological pain during a major depressive episode may be a factor of vulnerability to suicidal behavior, by increasing the propensity to suicidal ideation. Measuring and taking care of psychache during a depressive episode should be a major therapeutic target during crisis intervention.
authors.affiliation: Université Montpellier 1, Montpellier, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Olié
authors.forename: Sébastien
authors.initials: S
authors.lastname: Guillaume
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaussent
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
authors.forename: Fabrice
authors.initials: F
authors.lastname: Jollant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003419:Crisis Intervention; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013850:Thinking; D055815:Young Adult