Reasons to live during a suicidal crisis: A case series with suicidal inpatients

Abstract: Background: Following experts' recommendations for a phenomenological approach to suicidal behavior, this study opted to focus on the life-protecting beliefs and values expressed by people in acute suicidal crisis. Method: 61 adults hospitalized in psychiatric emergency for suicidal crises were assessed in terms of reasons for living (RFL) and suicidality. Multiple correspondence analysis was used to discern groups of patients based on their RFL profiles. Group differences on suicidality were further examined. Results: 4 groups of patients were observed, emerging from RFL differences in "Survival and Coping Beliefs", "Fear of Social Disapproval", "Responsibility to Family" and "Child-Related Concerns". Profiles varied by gender but not age. We further observed that "Survival and Coping Beliefs" and "Moral Objections" are weakened during an acute suicidal crisis. Conclusions: These findings underline the clinical utility of evaluating RFL during a suicidal crisis, and that RFL may be useful to personalize case formulation during an emergency intervention. They could further increase therapeutic communication by connecting the individual to key psychological resources. Longitudinal studies are necessary to evaluate how the different groups identified in this study may yield specific post-emergency trajectories connected to specific clinical needs.