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Persistent suicidality: a concept analysis using Rodgers' evolutionary approach
Fenny Merbis1, Mette Palm1,2, Els van Wijngaarden3
1Department of Psychiatry, Amsterdam University Medical Centre, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
International Review of Psychiatry (Abingdon, England)
|June 10, 2026
Summary
Persistent suicidality (PS) is a chronic condition, not just an acute crisis. This study clarifies PS as a transdiagnostic, ego-syntonic phenomenon used for psychological regulation, needing tailored clinical care.
Area of Science:
- Psychiatry
- Psychology
- Clinical Neuroscience
Background:
- Suicidality is typically viewed as an acute crisis.
- Persistent suicidality (PS) is underdefined, lacking conceptual clarity and consistent operationalization in existing literature.
Purpose of the Study:
- To clarify the concept of persistent suicidality (PS).
- To establish conceptual groundwork for viewing PS as a transdiagnostic phenomenon.
Main Methods:
- An evolutionary concept analysis of existing literature was performed.
- A systematic search across six databases identified 45 sources (1974-2025).
- Data were narratively synthesized using Rodgers' evolutionary framework.
Main Results:
- Persistent suicidality (PS) is characterized as an ego-syntonic, fluctuating phenomenon.
- A core attribute of PS is its function as a tool for psychological regulation.
- PS manifests across various psychiatric diagnoses, not solely personality pathology.
Conclusions:
- Persistent suicidality (PS) is a transdiagnostic phenomenon.
- Clinical care protocols for acute suicidality may not adequately address the nature of PS.
- A dimensional perspective is supported over rigid diagnostic categories for capturing PS.
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