Violent and Nonviolent Suicidal Ideation: Predictors of Suicide Crisis Syndrome Severity in a Longitudinal Study

Suicide Crisis Syndrome (SCS), an acute cognitive-affective state, has been shown to predict near-term suicidal behaviors, highlighting the need to understand factors associated with its severity. This study examined the relationship between SCS severity and different types of suicidal ideation (violent, nonviolent, and passive).

622 adult psychiatric inpatients were assessed at intake, discharge, and one-month post-discharge follow-up. Suicidal ideation types (SI) were collected using the Columbia-Suicide Severity Rating Scale and classified as violent, non-violent, or passive. One-way ANOVA, repeated measures ANCOVA, and binary logistic regressions examined SCS differences and temporal patterns across ideation types.

SCS severity significantly differed by ideation type. Individuals with violent SI had higher SCS severity than those with passive SI. In the exploratory analysis (N = 56), violent SI showed a steady decline, whereas nonviolent SI increased at one-month follow-up. Greater SCS severity at discharge also predicted nonviolent ideation at one-month follow-up.

SI content may provide different information across stages of an acute suicidal crisis. Violent SI may be relevant to concurrent crisis severity, whereas nonviolent SI may warrant attention during the post-discharge period. Assessing SCS severity alongside SI content may provide a more nuanced understanding of acute risk.