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

Alessandra Costanza, Marc Baertschi, Hélène Richard-Lepouriel, Kerstin Weber, Isabella Berardelli, Maurizio Pompili and Alessandra Canuto
Additional contact information
Alessandra Costanza: Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland
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

IJERPH, 2020, vol. 17, issue 7, 1-12

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.

Keywords: suicide; suicidal behavior; suicidal ideation; suicide attempt; demoralization; risk factor; emergency department (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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