Understanding suicide inpatients with treatment-resistant depression from the perspective of the Integrated Motivational-Volitional model of suicidal behavior

Background: Patients with treatment-resistant depression (TRD) are at a higher risk of suicide. Current studies investigating both protective and risk factors were limited. This study aimed to utilize the framework of the  integrated motivational–volitional model of suicidal behavior to gain a better understanding of suicidality in the population. Method: The participants were recruited through psychiatrists’ referrals in two general hospitals in  northern Taiwan. Structured questionnaires were administered by a research assistant for data collection of demographics as well as resilience characteristics, suicidality, and psychosocial variables. Results: Significant  differences were found between groups with a variety of suicidality (i.e., past-week suicide ideation, lifetime suicide attempt/self-harm, and future suicide intention) and the corresponding groups without suicide risks on the  designated risk and protective suicide variables. Noticeably, resilience, inferiority, and hopelessness were found to be the main variables that significantly affected all of the three suicidality outcomes. Conclusion: Several factors  (e.g., resilience and inferiority) were identified as potential key factors in suicide prevention among TRD patients in northern Taiwan. Further studies are needed to determine the directions of the relationships and their  associations with other possible factors to build a more comprehensive foundation of suicide prevention for the targeted populations.