Reduced Trust in Bodily Sensations Predicts Suicidal Ideation in Hospitalized Patients With Major Depression: An Observational Study.

Background: Major depressive disorder (MDD) is associated with maladaptive self-reported interoception, that is, abnormal bodily self-experience. Although diminished body trust predicts suicidal ideation, interoceptive measures have not been considered in depressed inpatients, whose suicide risk regularly peaks post-discharge. This study aims to explore interoceptive characteristics at admission that help identify inpatients at risk for suicidal ideation at discharge.

Methods: The observational study included 87 depressed inpatients providing self-ratings at both hospital admission (T0) and discharge (T1) on the BDI-II and MAIA-2. The statistical analysis included hierarchical logistic regression models and used ROC curve analysis to establish optimal cutpoints.

Results: Suicidal ideation was found in 17.24% of patients at discharge, who reported lower baseline MAIA-2 Trusting scores than non-ideators (p = 0.01). Diminished Trusting (OR = 0.19), somatic comorbidity (OR = 16.77), and baseline suicidal ideation (OR = 24.01) significantly predicted suicidal ideation (T1). For Trusting, we estimated an optimal classification of subsequent suicidal ideation for the cutpoint ≤ 2.33 (AUC = 0.70 [95% CI 0.57, 0.83], sensitivity = 0.87, specificity = 0.44, positive predictive value = 0.25, negative predictive value = 0.94).

Conclusions: Diminished body trust is a significant predictor for post-treatment suicidal ideation in depressed inpatients. This finding emphasizes the importance of incorporating body-centered approaches into multimodal treatment strategies, especially in inpatients under risk to prevent suicidal incidents.