Longitudinal association between stigma and suicidal ideation among patients with major depressive disorder

To explore the longitudinal associations between stigma and suicidal ideation among patients with major depressive disorder (MDD).

Data were from patients with MDD in the Depression Cohort in China. At baseline and weeks 4, 8, 12, 24, 48, and 72, the presence (yes and no) and severity (scores) of suicidal ideation were evaluated using the Beck Scale for Suicide Ideation, and stigma was assessed using the Depression Stigma Scale. Generalized linear mixed models were used to explore the association between stigma and suicidal ideation.

Among 1123 patients with a mean age of 27.9 (SD, 7.3) years, 71.1 % were female. Restricted cubic splines showed positive linear dose-response associations of personal stigma and perceived stigma with the likelihood and severity of suicidal ideation. The adjusted ORs (95 % CIs) for each 10 score increment in personal stigma and perceived stigma were 1.49 (1.18, 1.89) and 1.46 (1.20, 1.77) for the likelihood of suicidal ideation, respectively. The adjusted β coefficients (95 % CIs) for each 10 score increment in personal stigma and perceived stigma were 0.222 (0.121, 0.322) and 0.202 (0.123, 0.281) for suicidal ideation scores, respectively.

Information on sigma, suicidal ideation, and potential covariates was self-reported, so reporting bias was inevitable.

In this longitudinal study in patients with MDD, more severe personal stigma and perceived stigma were associated with a higher likelihood of suicidal ideation and more severe suicidal ideation. These findings suggest that reducing personal stigma and perceived stigma may help prevent suicidal behavior among patients with MDD.