Alexithymia, suicidal ideation and hopelessness levels in major depressive disorder patients with and without suicide attempts

Objectives: It is known that hopelessness and alexithymia levels are increased in patients with depressive disorder. In the literature, there are reports suggesting that high levels of hopelessness in patients with depressive disorder increase suicide attempts and ideations. Here we aimed to investigate whether there are any differences in terms of suicidal ideation, hopelessness and alexithymia levels between patients with and without suicide attempts who are diagnosed with major depressive disorder.

Methods: In this study, 99 patients diagnosed with major depressive disorder according to structured interview for DSM-IV (SCID-I/CV) and 50 healthy volunteers were included. Sociodemographic questionnaire, Toronto Alexithymia Scale (TAS), Beck Hopelessness Scale (BHS), Scale for Suicide Ideation (SSI) and Hamilton Depression Scale (HDS) were applied to patients and controls. Additionally, Suicide Intent Scale (SIS) was applied to patients with suicide attempt.

Results: There were significant differences in all scales and subscales between major depressive patients with or without suicide attempts and healthy controls (p<0.001). According to a cutoff point of 61 for TAS, 34% (n=34) of the patient group was alexithymic and 65% (n=65) was non-alexithymic. 67.6% (n=23) of the alexithymic major depressive patients and 29.2% (n=19) of the non-alexithymic major depressive patients had attempted suicide. The difference between these two groups was statistically significant (p<0.01). Mean scores of Scale for Suicide Ideation (SSI) in alexithymic and non-alexithymic patients were 10.91±3.47 and 5.59±3.87, respectively; the difference between them was statistically significant. Also the difference of Beck Hopelessness Scale (BHS) scores between the two group was statistically significant and mean scores were 11.24±6.15 and 6.58±5.69, respectively (p<0.01).

Conclusion: In our study, alexithymia, suicidal ideation, hopelessness and depression levels were higher in major depression patients with suicide attempt. Higher incidence of suicide attempts in major depressive patients with higher alexithymia levels and higher levels of suicidal ideation and hopelessness in this group of patients suggest the possibility of alexithymia as a predictive factor for suicide attempt.