title: Relationship of optimism and suicidal ideation in three groups of patients at varying levels of suicide risk.
abstract: Optimism has been associated with reduced suicidal ideation, but there have been few studies in patients at high suicide risk. We analyzed data from three study populations (total N = 319) with elevated risk of suicide: (1) patients with a recent acute cardiovascular event, (2) patients hospitalized for heart disease who had depression or an anxiety disorder, and (3) patients psychiatrically hospitalized for suicidal ideation or following a suicide attempt. For each study we analyzed the association between optimism (measured by the Life-Orientation Test-Revised) and suicidal ideation, and then completed an exploratory random effects meta-analysis of the findings to synthesize this data. The meta-analysis of the three studies showed that higher levels of self-reported optimism were associated with a lower likelihood of suicidal ideation (odds ratio [OR] = .89, 95% confidence interval [CI] = .85-.95, z = 3.94, p < .001), independent of age, gender, and depressive symptoms. This association held when using the subscales of the Life Orientation Test-Revised scale that measured higher optimism (OR = .84, 95% CI = .76-.92, z = 3.57, p < .001) and lower pessimism (OR = .83, 95% CI = .75-.92], z = 3.61, p < .001). These results also held when suicidal ideation was analyzed as an ordinal variable. Our findings suggest that optimism may be associated with a lower risk of suicidal ideation, above and beyond the effects of depressive symptoms, for a wide range of patients with clinical conditions that place them at elevated risk for suicide.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: jhuffman@partners.org.
authors.forename: Jeff C
authors.initials: JC
authors.lastname: Huffman
authors.affiliation: Department of Psychology, Chapman University, Orange, CA, USA.
authors.forename: Julia K
authors.initials: JK
authors.lastname: Boehm
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Beach
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Eleanor E
authors.initials: EE
authors.lastname: Beale
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Christina M
authors.initials: CM
authors.lastname: DuBois
authors.affiliation: Department of Neurology, Harvard Medical School, Boston, MA, USA; Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Healy
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D006801:Humans; D064887:Observational Studies as Topic; D000067656:Optimism; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology
keywords: Depression; Optimism; Risk assessment; Suicidal ideation; Suicide