Weekly Mind Reader: Psychological Pain as a Suicide Risk Factor

by Denis Storey
April 12, 2024 at 8:24 AM UTC

This week we report on a bevy of clozapine research, a promising Esmethadone case study, and let our readers take it from there.

The Journal of Clinical Psychiatry published a paper that takes a deeper look into psychological pain as a potential mental health indicator.

Psychological Pain as a Risk Factor for Suicidal Ideation

In a two-year study published in The Journal of Clinical Psychiatry, researchers investigated psychological pain as a potential risk factor for suicidal ideation in psychiatric inpatients with depression. The study included patients with and without borderline personality disorder.

Working with ecological momentary assessments, researchers collected data on PP, depression severity, SI, and hopelessness several times a day from 67 inpatients. The paper reports that the analysis revealed several key findings.

To start, the researchers found a correlation between PP and hopelessness, depression, and anxiety. Even so, it remained at least somewhat independent even after controlling for these variables. This means, the authors suggest, that PP represents a distinct experience beyond these other common mental health factors.

Secondly, PP emerged as a significant predictor of SI, both independently and alongside depression and hopelessness. This reveals the importance of considering PP in understanding the variability of SI within individuals, especially in the short term.

Finally, patients with depression and comorbid BPD reported higher levels of PP and SI compared to those without. And, PP showed greater fluctuations over time in patients with BPD, indicating a higher level of unpredictability in this population.

These findings contribute to a better grasp of the role of PP in the suicidal process, hinting that it might be as relevant as other mental health markers. The study emphasized the need for further research with larger samples and longer follow-up periods to back up these results and explore the predictive value of PP for suicidal behaviors beyond ideation.


  • A case report details how Kleine-Levin syndrome, a rare neurological disorder characterized by episodes of hypersomnolence, hyperphagia, hypersexuality, and hallucinations, can pose diagnostic challenges and might demand multidisciplinary cooperation.
  • Multiple papers expose a link between antipsychotics and metabolic functions, highlighting the importance of cautious prescribing practices.
  • A patient with schizoaffective disorder was found to have supratherapeutic lithium serum concentrations following sudden caffeine reduction and management with lithium dosage reduction precipitated exacerbation of psychiatric symptomatology.
  • A 43-year-old woman with no psychiatric history developed schizophreniform psychotic symptoms after taking ayahuasca, which resolved after 1 week of risperidone treatment.
  • Anxious personality types have a harder time with hypothyroidism, emphasizing the importance of the mind-body connection in patient care.

Original Research

The Relationship of Anxious Arousal With Treatment of Dysphoria Using Virtual Reality Mindfulness and 2 Accelerated Transcranial Magnetic Stimulation Protocols

Baseline levels of anxious arousal were not predictive of outcomes of treatment with VR or accelerated TMS.

Austin M. Spitz and others

Case Report

The Psychiatric Presentation of Creutzfeldt-Jakob Disease

This case highlights the difficulty in controlling symptoms such as agitation and visual hallucinations in patients with Creutzfeldt-Jakob Disease.

Beatrice M. Thungu and others