EPV667 - Social connectedness as a predictor of suicidal outcomes in psychiatric outpatients: A 12-month prospective EMA study
EPV667
Social connectedness as a predictor of suicidal outcomes in psychiatric outpatients: A 12-month prospective EMA study
A. A. Porras-Segovia 1,*, F. M. Herrmann 2, L. Albarracín-García 1, C. Díaz-Téllez 3, E. Baca-García 1
1Translational Psychiatry, Health Research Institute Fundación Jiménez Díaz, Madrid, Spain, 2Psychology, Harvard University , Boston, United States, 3Hospital Clinic, Barcelona, Spain
Introduction: Suicide is a leading global public health problem, accounting for over 700,000 deaths each year. Beyond its lethality, suicidal thoughts and behaviours carry a significant morbidity burden. Social connectedness has been identified as a key protective factor for suicide, yet most studies rely on static, cross-sectional assessments. Ecological Momentary Assessment (EMA) allows for the capture of real-time fluctuations in risk factors and the protective nature of social connectedness.
Objectives: This study aims to advance the field by examining the prospective association between EMA-measured social connectedness and suicidal outcomes (both EMA-based and EHR outcomes), over a 12-month EMA follow-up period.
Methods: We conducted a 12-month prospective EMA study involving 550 psychiatric outpatients from four Spanish hospitals who had experienced recent suicidal thoughts or attempts. Participants received a daily survey containing 2–4 randomly selected items from a pool of 34. These items included measures of social connectedness, active and passive suicidal ideation, and non-suicidal self-injury (NSSI). Information on suicide attempts was extracted from electronic medical records. Multilevel mixed-effects models were used to distinguish between-person (average levels) and within-person (daily deviations) associations, adjusting for age, sex, time, and missingness.
Results: Across 81,023 completed assessments, higher average connectedness was significantly associated with lower active suicidal ideation (b = −0.18, p = .014) and NSSI (b = −0.28, p = .003). Within-person increases in connectedness also predicted reductions in active suicidal ideation (b = −0.12, p < .001), but not NSSI or passive ideation. Lastly, the only significant predictor of suicide attempts was the missingness of active suicidal ideation EMA in the 7 days prior.
Table 1. Descriptive and variability statistics for suicide outcomes and social connectedness. | |||||||||
|
|
Descriptive statistics |
|
Variability statistics | ||||||
|
Variable |
M |
SD |
Range |
% nonzero |
|
ICC |
RMSSD | ||
|
Active suicidal ideation |
50.096 |
34.144 |
0-100 |
93 |
|
0.079 |
36.785 | ||
|
Passive suicidal ideation |
44.856 |
33.243 |
0-100 |
89.9 |
|
0.106 |
39.416 | ||
|
Non-suicidal self-injury |
14.464 |
25.823 |
0-100 |
51.5 |
|
0.243 |
21.458 | ||
|
Social connectedness |
49.357 |
33.586 |
0-100 |
91 |
|
0.18 |
37.236 | ||
|
Note. M = mean; SD = standard deviation; % nonzero = proportion of responses greater than zero; ICC = intraclass correlation coefficient, indexing the proportion of variance attributable to between-person differences; RMSSD = root mean square of successive differences. | |||||||||
Conclusions: Social connectedness predicts active suicidal ideation at both the between- and within-person levels. Lower connectedness is also associated with a greater risk of NSSI. Long-term EMA offers valuable insights suggesting that connectedness should be incorporated into suicide monitoring and intervention strategies.
Disclosure of Interest: None Declared