Rorschach Suicide Indicators and Constellation: A Narrative Review

Context: Suicide attempt is a common high-risk behavior, and early detection is crucial for prevention and treatment. There is limited research on suicide indices in the Rorschach test. Therefore, the purpose of this review study was to assess studies related to suicide indicators in the Rorschach test to determine whether the use of this test can indicate the risk of suicide among people or not. Methods: All databases, including PubMed, Science Direct, and Scopus, were used based on “Suicide” AND “Rorschach” keywords from 1960 to the end of 2019. Screening and selection of articles and their quality evaluation were carried out by two reviewers independently. Of the 554 articles in the initial search, 21 passed the evaluation stage. Results: Given that 21 articles were included in this research, color-shading responses are considered the most critical suicide indices using the single-sign approach. Hertz's multiple-signs approach and Exner’s suicide constellation are among the most commonly used indices for suicide risk assessment. A total S-CON score of 8 or higher in the Rorschach test is a powerful predictor of suicide risk. Conclusions: Preventing suicide is a horrific but crucial responsibility. Early identification of suicidal thoughts can save the lives of many. Projective tests such as Rorschach can be used with clinical interviews to detect thoughts and suicide attempts.