Associations between psychiatric diagnoses, comorbidity, and psychological pain across suicide-related presentations:...

Suicidal ideation and behaviour (SIB) occur across various psychiatric disorders. Although certain disorders are associated with elevated rates of SIB, diagnostic labels alone provide limited information about suicide-related presentations. Psychological pain has been proposed as an important experiential process operating across diagnostic boundaries, but its relationship with psychiatric comorbidity remains poorly understood. This study examined associations between psychiatric diagnoses, the number of co-occurring diagnoses, and psychological pain across clinical groups differing in suicide-related presentations.

N = 233 psychiatric inpatients were recruited (recent suicide attempters [SUAT], recent suicide ideators [SUID], clinical controls [CLIN]). Psychiatric diagnoses were assessed using the Mini-International Neuropsychiatric Interview; psychological pain was measured using the Mee-Bunney Psychological Pain Assessment Scale. Analyses evaluated group differences in the number of diagnoses and psychological pain, their association, and diagnostic patterns.

SUAT and SUID had higher mean numbers of diagnoses than CLIN; these did not differ between SUAT and SUID. Psychological pain differed across all groups and was positively associated with the number of diagnoses across the sample and within each group. Affective-anxiety and alcohol-dysthymic profiles were associated with suicide-related status.

The number of diagnoses did not reflect differences between suicide-related groups. Although suicidal groups displayed greater diagnostic complexity than non-suicidal controls, differences between ideation and attempt were not mirrored by the number of diagnoses. Psychological pain differentiated all groups and was associated with the number of diagnoses. These findings suggest that psychological pain captures aspects of suicide-related clinical states not fully represented by diagnostic descriptions alone.