Mental Pain and Suicide: A Systematic Review of the Literature.

Maria Cristina Verrocchio,Danilo Carrozzino,Per Bech,Daniela Marchetti,Mario Fulcheri,Kate Andreasson

doi:10.3389/fpsyt.2016.00108

Maria Cristina Verrocchio, Danilo Carrozzino + Show 4 more

Open Access

https://doi.org/10.3389/fpsyt.2016.00108

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Abstract

Mental pain, defined as a subjective experience characterized by perception of strong negative feelings and changes in the self and its function, is no less real than other types of grief. Mental pain has been considered to be a distinct entity from depression. We have performed a systematic review analyzing the relationship between mental pain and suicide by providing a qualitative data synthesis of the studies. We have conducted, in accordance with PRISMA guidelines, a systematic search for the literature in PubMed, Web Of Science, and Scopus. Search terms were "mental pain" "OR" "psychological pain" OR "psychache" combined with the Boolean "AND" operator with "suicid*." In addition, a manual search of the literature, only including the term "psychache," was performed on Google Scholar for further studies not yet identified. Initial search identified 1450 citations. A total of 42 research reports met the predefined inclusion criteria and were analyzed. Mental pain was found to be a significant predictive factor of suicide risk, even in the absence of a diagnosed mental disorder. Specifically, mental pain is a stronger factor of vulnerability of suicidal ideation than depression. Mental pain is a core clinical factor for understanding suicide, both in the context of mood disorders and independently from depression. Health care professionals need to be aware of the higher suicidal risk in patients reporting mental pain. In this regard, psychological assessment should include a clinimetric evaluation of mental pain in order to further detect its contribution to suicidal tendency.

Highlights

The World Health Organization estimated 804,000 suicide deaths occurred worldwide in 2012, representing an annual global age-standardized suicide rate of 11.4 per 100,000 population (15.0 for males and 8.0 for females)
When taking into consideration the evidence that there are, on the one hand, depressed patients who did not die by suicide, and, on the other hand, not clinically depressed suicide attempters, several authors have proposed that there is a core risk factor for suicide, which has been conceptualized as psychache or psychological pain (11)
Psychache partially mediated the relationship between life satisfaction and suicidal ideation. These findings indicate that life satisfaction may relieve the psychache and, reduces the risk for suicidal ideation and suicide attempt

Summary

Introduction

The World Health Organization estimated 804,000 suicide deaths occurred worldwide in 2012, representing an annual global age-standardized suicide rate of 11.4 per 100,000 population (15.0 for males and 8.0 for females). When taking into consideration the evidence that there are, on the one hand, depressed patients who did not die by suicide, and, on the other hand, not clinically depressed suicide attempters, several authors have proposed that there is a core risk factor for suicide, which has been conceptualized as psychache or psychological pain (11). In this regard, a recent research report from Soumani et al (12) highlighted that this type of mental pain contributes significantly to suicide risk independent of depression. We have performed a systematic review analyzing the relationship between mental pain and suicide by providing a qualitative data synthesis of the studies

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