High depression symptomatology and mental pain characterize suicidal psychiatric patients

Maurizio Pompili¹, Marco Innamorati², Denise Erbuto¹, Mario Luciano³, Gaia Sampogna³, Giovanni Abbate-Daga⁴, Stefano Barlati^{5

6}, Claudia Carmassi⁷, Giovanni Castellini⁸, Pasquale De Fazio⁹, Giorgio Di Lorenzo¹⁰, Marco Di Nicola^{11

12}, Silvia Ferrari^{13

14}, Arianna Goracci¹⁵, Carla Gramaglia^{16

17}, Giovanni Martinotti¹⁸, Maria Giulia Nanni¹⁹, Massimo Pasquini²⁰, Federica Pinna²¹, Nicola Poloni²², Gianluca Serafini²³, Maria Signorelli²⁴, Alfonso Tortorella²⁵, Antonio Ventriglio²⁶, Umberto Volpe²⁷, Andrea Fiorillo³

Affiliations

¹ Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
² Department of Human Sciences, European University of Rome, Rome, Italy.
³ Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.
⁴ Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy.
⁵ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
⁶ Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy.
⁷ Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
⁸ Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy.
⁹ Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy.
¹⁰ Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
¹¹ Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.
¹² Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
¹³ Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
¹⁴ Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, AUSL - IRCCS Reggio Emilia, Reggio Emilia, Italy.
¹⁵ Department of Molecular Medicine, University of Siena, Siena, Italy.
¹⁶ Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
¹⁷ Psychiatry Division, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy.
¹⁸ Department of Neuroscience, Imaging and Clinical Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.
¹⁹ Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.
²⁰ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
²¹ Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
²² Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
²³ Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy.
²⁴ Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy.
²⁵ Department of Psychiatry, University of Perugia, Perugia, Italy.
²⁶ Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
²⁷ Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy.

PMID: 36041998
PMCID: PMC9491079
DOI: 10.1192/j.eurpsy.2022.2312

High depression symptomatology and mental pain characterize suicidal psychiatric patients

Maurizio Pompili et al. Eur Psychiatry. 2022.

. 2022 Aug 31;65(1):e54.

doi: 10.1192/j.eurpsy.2022.2312.

Authors

Affiliations

¹ Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
² Department of Human Sciences, European University of Rome, Rome, Italy.
³ Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.
⁴ Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy.
⁵ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
⁶ Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy.
⁷ Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
⁸ Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy.
⁹ Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Catanzaro, Italy.
¹⁰ Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
¹¹ Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.
¹² Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
¹³ Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
¹⁴ Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, AUSL - IRCCS Reggio Emilia, Reggio Emilia, Italy.
¹⁵ Department of Molecular Medicine, University of Siena, Siena, Italy.
¹⁶ Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
¹⁷ Psychiatry Division, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy.
¹⁸ Department of Neuroscience, Imaging and Clinical Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.
¹⁹ Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.
²⁰ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
²¹ Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
²² Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
²³ Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy.
²⁴ Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy.
²⁵ Department of Psychiatry, University of Perugia, Perugia, Italy.
²⁶ Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
²⁷ Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy.

PMID: 36041998
PMCID: PMC9491079
DOI: 10.1192/j.eurpsy.2022.2312

Abstract

Background: Symptoms of depression are transdiagnostic heterogenous features frequently assessed in psychiatric disorders, that impact the response to first-line treatment and are associated with higher suicide risk. This study assessed whether severe mental pain could characterize a specific phenotype of severely depressed high-risk psychiatric patients. We also aimed to analyze differences in treatments administered.

Methods: 2,297 adult patients (1,404 females and 893 males; mean age = 43.25 years, SD = 15.15) treated in several Italian psychiatric departments. Patients were assessed for psychiatric diagnoses, mental pain, symptoms of depression, hopelessness, and suicide risk.

Results: More than 23% of the patients reported high depression symptomatology and high mental pain (HI DEP/HI PAIN). Compared to patients with lower symptoms of depression, HI DEP/HI PAIN is more frequent among females admitted to an inpatient department and is associated with higher hopelessness and suicide risk. In addition, HI DEP/HI PAIN (compared to both patients with lower symptoms of depression and patients with higher symptoms of depression but lower mental pain) were more frequently diagnosed in patients with personality disorders and had different treatments.

Conclusions: Patients reporting severe symptoms of depression and high mental pain presented a mixture of particular dangerousness (high trait hopelessness and the presence of suicide ideation with more frequency and less controllability and previous suicide behaviors). The presence of severe mental pain may act synergically in expressing a clinical phenotype that is likewise treated with a more complex therapeutic regime than that administered to those experiencing symptoms of depression without mental pain.

Keywords: Depression symptomatology; hopelessness; mental pain; psychopharmacological medications; suicide behaviors and ideation.

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References

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High depression symptomatology and mental pain characterize suicidal psychiatric patients

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High depression symptomatology and mental pain characterize suicidal psychiatric patients

Authors

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Abstract

References

MeSH terms

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Medical