It is well-known that depression is one of the significant risk factors for suicidality, but alone it is not sufficient.

Research has shown that the correlation between depression and suicidality became non-significant when hopelessness was statistically controlled, and that it is psychache that directly leads to suicide and mediates the effects of depression and hopelessness. We therefore explored depression, hopelessness and psychache (DHP) as a predictors of suicidality in patients diagnosed with psychotic disorders (PDs).

To identify patients at risk of suicidality.

The study sample consisted of 59 patients diagnosed with a PDs (schizophrenia spectrum and delusional disorders), mean age of 35.25 years (SD 8.25). Assessment instruments included the Beck Scale for Suicide Ideation, the Beck Depression Inventory II, the Beck Hopelessness Scale and The Psychache Scale.

There was a positive correlation between DHP and intensity of suicidality and factors of suicidal motivation and preparation. Regression analysis indicates that DHP contribute to 45,9% of the variance of intensity of suicidality (F=17,433, df=3, p 0,01), to 32.9% of the variance of suicidal motivation (F = 10.479, df = 3, p 0,01), and to 57.1% of the variance of suicidal preparation (F = 26.775, df = 3, p 0,01). Depression was the only significant predictor of intensity of suicidality and suicidal motivation, with hopelessness as the only significant predictor of suicidal preparation.

In patients diagnosed with PDs, depression was a significant predictor of intensity of suicidality and suicidal motivation, and hopelessness was a significant predictor of suicidal preparation.