Serial multiple mediation of demoralization and depression in the relationship between hopelessness and suicidal ideation
Menée en Chine par questionnaire auprès de 244 patients atteints d’un cancer, cette étude analyse l’association entre des symptômes de démoralisation et de dépression, un sentiment d’absence d’espoir et des idées de suicide
Objective : Suicidal ideation is common in cancer patients and may be associated with hopelessness, demoralization, and depression. This study aims to investigate the serial multiple mediation of demoralization and depression in the relationship between hopelessness and suicidal ideation in cancer patients. Methods : A total of 244 cancer patients were investigated by using the following standardized self-reported questionnaires: Self-rating Idea of Suicide scale (SIOSS), Beck Hopelessness Scale (BHS), Demoralization Scale-Mandarin Version (DS-MV), and Patient Health Questionnaire depression scale?9 (PHQ?9). The mediation hypothesis was tested with a serial multiple mediation model (PROCESS model 6). An exploratory graph analysis was performed to detect the correlations among the dimensions of the mental conditions measured by these instruments. Results : Bootstrap analyses indicate that there were direct and indirect effects of hopelessness on suicidal ideation mediated solely by demoralization (B = 2.3074, SE = 0.1724, P <0.001) or by demoralization together with depression (B = 0.1605, SE = 0.0303, 95% confidence interval = 0.1102-0.2303). The mediation of depression alone in the relationship between hopelessness and suicidal ideation was insignificant (B = 0.1541, SE = 0.0519, 95% confidence interval = ?0.0565?0.0715). The exploratory graph analysis suggests that the strongest edge of dimensions between demoralization and suicidal ideation was desperation?disheartenment (0.62). Conclusions : The results of the study support the hypothesis that demoralization and depression mediate between hopelessness and suicidal ideation. The early identification of and interventions for hopelessness, demoralization, and depression may prevent cancer patients from developing suicidal ideation.
Psycho-Oncology 2020