Psychological distress and suicidal ideation in patients with depressive disorders: the chain mediation of psychological resilience and neuroticism

Int J Nurs Stud Adv. 2025 Apr 8;8:100325. doi: 10.1016/j.ijnsa.2025.100325. eCollection 2025 Jun.

ABSTRACT

OBJECTIVE: Suicide in depressed patients has become a serious challenge in the field of public health. In-depth analyses of the relationship between psychological distress and suicidal ideation, as well as its intrinsic mechanisms, are of great clinical significance for the prevention of suicide in depressed patients. The objective of this study was twofold: firstly, to explore the intrinsic relationship between psychological distress and suicidal ideation in depth; and secondly, to further investigate the mediating roles of psychological resilience and neuroticism in this relationship.

METHODS: In this study, a cross-sectional research design was employed to select 200 patients diagnosed with depression from a mental health centre in Shandong Province. This study utilised the abbreviated version of the Big Five Personality Inventory, the Simplified Scale of Psychological Resilience, the Suicidal Ideation Scale, and the Kessler Psychological Distress Scale to administer questionnaires to patients.

RESULTS: Psychological distress has a direct predictive effect on suicidal ideation. In depressed patients, it also exerts an indirect effect on suicidal ideation via three pathways: the separate mediating effect of psychological resilience, the separate mediating effect of neuroticism, and the chain mediating effect of psychological resilience and neuroticism.

CONCLUSION: In conclusion, the results of this study elucidate the effect of psychological distress on suicidal ideation in depressed patients and its mechanism of action. Furthermore, they demonstrate the chain-mediated roles of psychological resilience and neuroticism in the relationship between psychological distress and suicidal ideation in depressed patients. Finally, they provide a new perspective for understanding suicidal ideation and preventing suicidal risk in depressed patients. Nevertheless, the present study was only able to measure the correlation between the variables; therefore, it is not yet possible to infer causality. In future, more precise prediction and intervention programmes for suicide risk in depressed patients can be explored in depth through longitudinal or experimental studies, etc.

PMID:40276211 | PMC:PMC12018043 | DOI:10.1016/j.ijnsa.2025.100325