Empathy, psychopathology and suicidal behavior: a case-control study

Patients with psychiatric disorders have high levels of self-oriented empathy, but dampened other-oriented empathy. Empathy characteristics in individuals who attempt suicide, and their relationships with psychopathology are not clear.

Altogether 62 suicide attempters, 64 non-suicidal psychiatric inpatients and 138 healthy controls filled-in self-reported questionnaires on empathy and psychopathology. The relationships between each empathy subscale, levels of psychopathology, and case-control groups were tested via linear regression models and in group-stratified analyses.

Cases had significantly higher Fantasy (FS) and Personal Distress (PD) scores than healthy controls. Higher levels of psychological distress were associated with higher scores of FS (2.10, 1.08‒3.13) and PD (2.90, 1.87‒3.93), irrespective of the group. With increasing psychopathology levels, scores of Perspective Taking decreased significantly in suicide attempters (-1.81, -3.55‒ -0.08), non-significantly in non-suicidal psychiatric inpatients (-1.11, -2.94‒0.73) and increased in healthy controls (0.79, -1.05‒2.64); conversely, PD increased significantly in healthy controls (4.91, 2.86‒6.96) and in psychiatric controls (2.89, 0.95‒4.82), but non-significantly among cases (1.60, -0.13‒3.33).

Empathy does not differ between suicidal and non-suicidal psychiatric patients. Psychopathology is related to empathic PD and FS. The relation is stronger in individuals with no psychiatric conditions than in psychiatric patients or suicide attempters. Emotional and self-oriented dimensions of empathy could contribute to the identification of people at risk of suicidal behavior.