Digital phenotypes of real-time suicidal ideation: Correlates and consequences

Area of Science:

• Psychiatry
• Digital Phenotyping
• Mental Health Research

Background:

• Suicidal ideation variability, defined as within-day fluctuations, is a potential indicator of suicide risk.
• Limited research exists on the clinical relevance and correlates of suicidal ideation variability.

Purpose of the Study:

• To investigate real-time suicidal ideation patterns using Ecological Momentary Assessment (EMA).
• To identify distinct subtypes (phenotypes) of suicidal ideation.
• To examine the clinical correlates and predictive value of these phenotypes for future suicide attempts.

Main Methods:

• Ecological Momentary Assessment (EMA) data collected four times daily for 21 days from 82 individuals with active suicidal ideation.
• Latent profile analysis to identify suicidal ideation phenotypes.
• Sociodemographic and clinical variables assessed, along with 1-year suicide attempt follow-up.

Main Results:

• Three "digital" phenotypes of suicidal ideation were identified based on frequency, intensity, and variability.
• Phenotypes 1 (high frequency/intensity, moderate variability) and 2 (moderate/high frequency, moderate intensity, high variability) showed worse baseline clinical profiles.
• Phenotypes 1 and 2 were associated with increased odds of suicide attempts during follow-up; Phenotype 1 indicated repeated suicidal behavior.

Conclusions:

• Two distinct phenotypes of real-time suicidal ideation characterized by high variability, intensity, and frequency appear to confer higher near-future suicide risk.
• These findings suggest potential clinical utility in identifying individuals at elevated risk for suicidal behavior.
• Further research with larger sample sizes is needed to confirm clinical usefulness.