Schema mode profiles and lifetime suicide attempts in patients with mood disorders in full remission: A latent...

Individuals with mood disorders face an elevated suicide risk, yet psychological vulnerabilities remain poorly characterized. Schema modes (SMs) may serve as promising markers of such vulnerabilities. This study employed a person-centered approach to identify SM profiles and examined their associations with lifetime suicide attempts in patients with fully remitted major depressive disorder (rMDD) or bipolar disorders (rBD).

Participants were 231 outpatients with rMDD (n = 118) or rBD (n = 113) (68.0% women; M_age= 33.5 years), all without diagnosed personality disorders. Latent profile analysis was conducted using 14 SM subscales from the Schema Mode Inventory. Analysis of covariance examined the effects of profile membership, diagnosis, and their interaction on lifetime suicide attempts, controlling for age and sex.

Three profiles were identified: Adaptive (31.6%), Mixed (44.2%), and Highly Maladaptive (24.2%). While the Mixed profile showed concurrent elevations in adaptive and maladaptive SMs, the Highly Maladaptive profile exhibited pervasive elevations in dysfunctional SMs. A significant profile × diagnosis interaction emerged (p = .014): among patients with rBD, the Highly Maladaptive profile was associated with significantly more lifetime suicide attempts than the Mixed profile, whereas no profile differences were observed among patients with rMDD.

SM configurations may represent a differential vulnerability factor for suicidal behavior, operating more strongly in rBD. These findings support SM profiling during full remission as a tool for suicide risk assessment and suggest that schema therapy strengthening adaptive SMs and attenuating maladaptive SMs may hold promise for suicide prevention in mood disorders, particularly BD.