The Effect of Depression, Stress, Coping Strategies on the Suicidal Ideation in Healthy Controls and Psychiatric Patients

Choongman Park; Jongseok Lim; Young Min Choi; Jangho Park; Soohyun Joe

doi:10.4306/jknpa.2017.56.2.68

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Park, Lim, Choi, Park, and Joe: The Effect of Depression, Stress, Coping Strategies on the Suicidal Ideation in Healthy Controls and Psychiatric Patients

Original Article

Journal of Korean Neuropsychiatric Association 2017; 56(2): 68-77.

Published online: 30 May 2017

DOI: https://doi.org/10.4306/jknpa.2017.56.2.68

The Effect of Depression, Stress, Coping Strategies on the Suicidal Ideation in Healthy Controls and Psychiatric Patients

Choongman Park, MD¹, Jongseok Lim, MD¹, Young Min Choi, MD, PhD¹, Jangho Park, MD, PhD¹, Soohyun Joe, MD, PhD²

¹Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

²Department of Psychiatric Rehabilitation, Bugok National Hospital, Changnyeong, Korea.

Address for correspondence: Soohyun Joe, MD, PhD. Department of Psychiatric Rehabilitation, Bugok National Hospital, 145 Bugok-ro, Bugok-myeon, Changnyeong 50365, Korea. Tel +82-55-536-6440, Fax +82-55-536-6444, biophilia1@paran.com

Received 9 August 2016 Revised 1 November 2016 Accepted 2 November 2016

Abstract

Objectives

The aim of this study was to compare the coping strategies among healthy controls, psychotic and neurotic patients and to evaluate the predictors of suicidal ideation.

Methods

The study population consisted of 115 outpatients in Ulsan University Hospital and 160 healthy controls. They filled out self-report questionnaires including demographics and validated psychiatric scales for depression, perceived stress, coping strategies, and suicide ideation. An analysis of the covariance was used to compare the clinical data among the groups. Stepwise multiple regression analysis was performed to estimate the effects of coping strategies and depression on the risk for suicidal ideation.

Results

Compared to the controls, the psychosis group used less active coping, and the neurosis group used more self-blame coping strategies. In healthy controls, suicidal ideation was predicted by depression, female gender, and using more self-blame coping. Although planning in psychosis was a protective factor, acceptance and self-blame in psychosis and behavioral disengagement in neurosis was a risk factor for suicidal ideation.

Conclusion

Patients with psychotic and neurotic disorders use different coping strategies to deal with their distress and some of those are risk factors for suicidal ideation. Therefore, improving coping skills will be helpful for preventing suicide by alleviating the levels of stress and providing more effective emotion regulation.

Keywords: Stress, Coping, Depression, Suicide, Psychosis, Neurosis

Figures and Tables

Table 1

ICD-10 diagnosis code of clinical group

ICD : International Classification of Diseases, GAD : Generalized anxiety disorder, MADD : Mixed anxiety and depressive disorder, PTSD : Post-traumatic stress disorder

Table 2

Sociodemographic characteristics of study subjects

Table 3

Clinical characteristics of participants

* : p<0.05, † : p<0.001. SSI : Scale for Suicide Ideation, PSS : Scale for Perceived Stress, BDI : Beck Depression Inventory, SD : Standard deviation, F : F value, η² : Partial eta squared, HC : Healthy control, P : Psychosis, N : Neurosis

Table 4

Stepwise multiple regression analysis for variables predicting suicidal ideation

* : p<0.05, † : p<0.001. SE : Standard error, VIF : Variance inflation factors, BDI : Beck Depression Inventory

Notes

^{Conflicts of Interest} The authors have no financial conflicts of interest.

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