Key Takeaways
Extended Takeaways
- In this postattempt sample, suicidal mental imagery identified a subgroup with greater current symptom burden: mean PHQ-9 scores were 14.67 versus 12.36 and mean MINI suicidality scores were 50.42 versus 42.97 compared with participants without imagery.
- Mental imagery was more frequent in participants with a psychiatric history, reported by 95.8% of the imagery group versus 69.2% of the nonimagery group (χ2 = 6.42, P = .01), supporting closer assessment in attempters with established mental illness.
- Female sex and lack of income were the only demographic variables associated with mental imagery in this sample: 25.4% of the total sample were female with imagery versus 12.7% male with imagery, and 79.2% of those with imagery had no income source versus 51.3% without imagery.
- The multivariable model including PHQ-9, suicidality, sex, and occupation significantly distinguished participants with versus without mental imagery (model χ2 (4) = 14.774, P = .005) and explained approximately 20.9% to 28.4% of the variance, suggesting these readily available clinical variables can help flag who may warrant more detailed imagery assessment.
- Most participants were already in a high-acuity range, with 96.8% showing a high suicidality score and 73.0% classified as medium risk, so the additional association of imagery with higher PHQ-9 and suicidality scores may help refine risk stratification even within an already high-risk postattempt population.
