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Demoralization and Its Relationship with Depression and Hopelessness in Suicidal Patients Attending an Emergency Department

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  • Alessandra Costanza

    (Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland
    Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, 15121 Alessandria, Italy)

  • Marc Baertschi

    (Service of General Psychiatry and Psychotherapy, Nant Foundation, 1820 Montreux, Switzerland)

  • Hélène Richard-Lepouriel

    (Service of Psychiatric Specialties, Department of Psychiatry, University Hospitals of Geneva, 1211 Geneva, Switzerland)

  • Kerstin Weber

    (Division of Institutional Measures, Medical Direction, University Hospitals of Geneva, 1211 Geneva, Switzerland)

  • Isabella Berardelli

    (Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy)

  • Maurizio Pompili

    (Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy)

  • Alessandra Canuto

    (Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland)

Abstract

Emergency departments (EDs) play an increasingly crucial role in the management of patients with suicidal behavior (SB). Demoralization has been associated with SB in various populations and conditions, but little is known about the effect of this construct in SB patients who attend an ED. Therefore, a more inclusive SB assessment which considers the demoralization construct could be useful in clinical practice. The main aim of this study was to assess the presence and severity of demoralization in patients visiting EDs for SB. Secondly, the maintenance of the relationship between demoralization and SB after controlling for depression and the proportion of variance which accounted for hopelessness was investigated. A cross-sectional study of patients ( N = 199) visiting an ED for SB was performed, which examined the role of demoralization, hopelessness, and depression on suicidal ideation (SI) and suicide attempts (SAs). Demoralization was strongly and positively correlated with SI. Demoralization was related to major depressive episodes, but it was confirmed to be a different and, probably, more sensitive construct for SB, validating its specificity in relation to depression. Hopelessness accounted for a small portion of the variance in SI, compared to demoralization. Formal support for the association of demoralization with SI was provided. Demoralization can improve SB assessment in EDs, particularly among patients whose suicide risk can be unnoticed. Furthermore, demoralization represents a clinically useful concept to increase comprehension of the suffering of the suicidal patient and a possible target for psychotherapeutic interventions.

Suggested Citation

  • Alessandra Costanza & Marc Baertschi & Hélène Richard-Lepouriel & Kerstin Weber & Isabella Berardelli & Maurizio Pompili & Alessandra Canuto, 2020. "Demoralization and Its Relationship with Depression and Hopelessness in Suicidal Patients Attending an Emergency Department," IJERPH, MDPI, vol. 17(7), pages 1-12, March.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:7:p:2232-:d:337400
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    References listed on IDEAS

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    1. Marc Baertschi & Alessandra Costanza & Alessandra Canuto & Kerstin Weber, 2018. "The Function of Personality in Suicidal Ideation from the Perspective of the Interpersonal-Psychological Theory of Suicide," IJERPH, MDPI, vol. 15(4), pages 1-14, March.
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    Cited by:

    1. Maria Clelia Zurlo & Federica Vallone & Maria Francesca Cattaneo Della Volta, 2022. "Perceived Past and Current COVID-19-Stressors, Coping Strategies and Psychological Health among University Students: A Mediated-Moderated Model," IJERPH, MDPI, vol. 19(16), pages 1-19, August.
    2. Jacqueline de Souza & Carla Aparecida Arena Ventura & Jordana Luiza Gouvêa de Oliveira & Loraine Vivian Gaino & Juliana Cristina dos Santos Monteiro & Jaqueline Lemos de Oliveira & Leticia Yamawaka de, 2021. "Experience of Vulnerable Women Narrated through the Body-Mapping Technique," IJERPH, MDPI, vol. 18(24), pages 1-15, December.
    3. Alessandra Costanza & Michalina Radomska & Francesco Zenga & Andrea Amerio & Andrea Aguglia & Gianluca Serafini & Mario Amore & Isabella Berardelli & Yasutaka Ojio & Khoa D. Nguyen, 2021. "Severe Suicidality in Athletes with Chronic Traumatic Encephalopathy: A Case Series and Overview on Putative Ethiopathogenetic Mechanisms," IJERPH, MDPI, vol. 18(3), pages 1-15, January.

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