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Suicidality and social cognition: the association between hypomentalizing and suicide lethality
Published online by Cambridge University Press: 27 August 2024
Abstract
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Introduction
Suicide attempts (SA) leading to highly lethal consequences have been associated with heightened suicide planning (Barker et al., 2022), along with deficits in social cognition (Levi-Belz et al., 2022). Hypomentalizing, characterized by excessive uncertainty regarding mental states, may contribute to heightened social withdrawal and an increased risk of SA (Nestor & Sutherland, 2022). Although certain studies have identified a connection between hypomentalizing profiles and self-harm (Badoud et al., 2015), research into the lethality of SA remains limited.
Objectives
This study aimed to explore the association between hypomentalizing and SA lethality.
Methods
Our study encompassed a cohort of 1,371 patients who committed a SA. We conducted assessments of mentalizing using the RFQ-8 instrument, and evaluations of suicidal ideation and behavior employing the CSRSS questionnaire. Demographic and clinical characteristics were compared using the T-student and Chi-square tests. To investigate the relationship between hypomentalizing and the SA lethality, we employed logistic regression models.
Results
Table 2.
Descriptive date are presented in Table 1. Our results show that hypomentalizing do not predict a higher SA lethality. Additionally, hypomentalizing increased the risk of SA planning (p≤0.001, B=-0.182), and SA planning predicted a higher SA lethality (see Table 2).Table 1.
Means Comparison for low and high lethality (N=1371)
| Low lethality N=539 | High lethality N=832 | p value | Effect size | |
|---|---|---|---|---|
| Age, mean (SD) | 38.65 (15.65) | 41.91 (15.37) | ≤0.001 | -0.209a |
| Female sex, N (%) | 392 (72.7) | 571 (68.6) | 0.116 | 0.044b |
| Educational years, mean (SD) | 12.45 (2.99) | 12.43 (3.41) | 0.890 | 0.0076a |
| Employed, N (%) | 220 (41.2) | 332 (40) | 0.692 | 0.012b |
| Suicide Ideation, N (%) | 475 (88.1) | 742 (89.2) | 0.541 | 0.016b |
| Suicide Planning, N (%) | 159 (39.2) | 400 (58.1) | ≤0.001 | 0.183b |
| Number of attempts, mean (SD) | 3.28 (5.48) | 3.63 (5.74) | 0.269 | -0.169a |
| RFQ, mean (SD) | 4.68 (1.27) | 4.56 (1.32) | 0.087 | 0.095a |
Logistic regression analyses for high SA lethality (N=1371).
| Univariate analysis | Multivariate analysis | |||
|---|---|---|---|---|
| OR | p value | OR | p value | |
| Age | 1.014 (1.007-1.021) | ≤0.001 | 1.014 (1.005-1.022) | 0.001 |
| Female sex | 0.820 (0.646-1.042) | 0.105 | ||
| Educational years | 0.998 (0.965-1.031) | 0.890 | ||
| Employed | 0.952 (0.763-1.187) | 0.660 | ||
| Suicide ideation | 1.111 (0.790-1.562) | 0.545 | ||
| Suicide planning | 2.150 (1.674-2.761) | ≤0.001 | 2.183 (1.697-2.808) | ≤0.001 |
| Number SA | 1.012 (0.990-1.034) | 0.277 | ||
| RFQ | 0.929 (0.854-1.011) | 0.088 | ||
Conclusions
While the association between hypomentalizing and high SA lethality was not significant, a discernible trend toward such relationship can be noted. Further studies examining the moderating effects of planning in the association between hypomentalizing and SA lethality are required.
Disclosure of Interest
None Declared
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- Information
- European Psychiatry , Volume 67 , Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry , April 2024 , pp. S183
- Creative Commons
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.- Copyright
- © The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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