Previous studies have provided evidence on the possible relationship between mental pain (psychache) and suicide. The aim of the present study was to investigate whether more intense psychache is related with higher suicide risk independently of the severity of depression.

Orbach's Mental Pain Scale was administered in 58 women with major depression: 24 inpatients and 34 outpatients. Severity of depressive symptoms was evaluated by the Beck Depression Inventory. Suicide Risk Scale was used for the assessment of suicide risk. Level of physical pain was measured by McGill Pain Questionnaire-Short form. Pearson's correlation was used to examine the relationship between variables and a multiple regression analysis was performed to examine the independent strength of the associations.

Suicide risk was significantly and positively associated with the level of current psychache and the severity of depressive symptoms, and negatively with the age of onset of the illness. The levels of physical pain or worst-ever psychache were also correlated with suicide risk; however, these associations did not remain significant in the multiple regression models.

Higher levels of mental pain may be a factor of vulnerability to suicidal behaviour in major depression. Higher symptom severity and earlier onset of the illness may also contribute to suicide risk. The association between physical pain and suicide risk appears to be mediated by mental pain or other aspects of the illness.