Relationships between suicidality, hopelessness and quality of life: a network analysis in a clinical inpatient sample of adults with research interview-confirmed major depressive disorder and suicidality ≥48 hours after hospitalization

Detailed information and author details can be found in the attached file. This project examines the relationships between suicidality, hopelessness, and quality of life in a clinical inpatient sample of adults with moderate to severe major depressive disorder (MDD) and persistent suicidality. Suicidal thoughts and behaviors in depression are complex and multidimensional, yet the ways in which specific psychological domains interact remain poorly understood. To address this gap, the present study applies a bayesian network analysis approach. Using data from the Outcomes Associated with Suicidality in Inpatients with Symptoms of Depression (OASIS-D) study, this analysis focuses on a well-defined high-risk population recruited from psychiatric inpatient units across eight German university hospitals. The sample includes adults aged 18–75 years with interview-confirmed MDD and clinically verified suicidal ideation or behavior persisting for at least 48 hours after admission. The primary aim is to estimate the network structure linking suicidal ideation, suicidal behavior, dimensions of hopelessness (optimism, failure expectations, and future uncertainty), and overall quality of life. Specifically, the study seeks to identify which variables are directly connected, the relative strength of these associations, and which relationships are absent when accounting for all other variables. A secondary aim is to determine which aspects of hopelessness and quality of life are most proximally associated with suicidality, thereby identifying potential targets for clinical intervention. A cross-sectional Bayesian network model for ordinal data is used to quantify conditional associations and uncertainty in network structure. Expected outcomes include a clearer understanding of how suicidality relates to hopelessness and quality of life in severely depressed inpatients and insights into psychological domains that may be particularly relevant for suicide prevention efforts in this population.