Reduced trust in bodily sensations predicts suicidal ideation

Rüdersdorf, 9 September 2025

Severely depressed individuals have a significantly increased suicide risk and on average a far shorter life expectancy compared to the general population. The phenomenon is particularly serious in bipolar disorders. It remains an unnerving experience for psychiatrists when – despite their intensive efforts – patients attempt suicide or die. To date, almost no reliable psychological or biological markers have been identified to indicate acute danger of suicide.

A team of researchers at the Brandenburg Medical School Theodor Fontane (MHB) recently developed an innovative diagnostic approach for early recognition of suicidal ideation in inpatients with unipolar depression. Results were published in a paper entitled “Reduced trust in bodily sensations predicts suicidal ideation in hospitalized patients with major depression: an observational study” in the journal Suicide and Life-Threatening Behavior.

Body trust as a new starting point

The researchers found that inpatients suffering severe depression had a higher risk of suicidal ideation the less they experienced their own body as safe and reliable. This observation is all the more important since no medication has been found so far to reliably reduce the suicide risk, apart from long-term therapy involving lithium.

Physicians frequently see cases where affected patients try to kill themselves shortly upon discharge and unexpectedly. Body trust is one aspect of interoception, i.e. the perception of signals from inside the body such as heartbeat, breathing or a sense of hunger, and may be captured by means of a simple threshold value via three short questions right at the start of an inpatient stay. This new risk marker helps physicians in the early identification of patients with impaired interoception who might be particularly at risk post-discharge.

Critical stage post-discharge

The transition period from intensive hospital care back into daily life is considered critical as affected individuals are frequently instable and receive little support. The first weeks post-discharge therefore involve a heightened risk of suicidal ideation and activities. The diagnostic procedure developed by the researchers offers a chance of early detection during inpatient treatment and initiation of targeted measures to prevent suicides.

Dr. Michael Eggart, visiting scientist at the center for mental health of the MHB university hospital Immanuel Klinikum Rüdersdorf, points to the difficulty of suicide prevention without reliable markers to predict suicidal ideation. Based on results of the study, he demands a stronger therapeutic focus on body sensations. MHB professor Bruno Müller-Oerlinghausen adds that practicing psychiatrists should take note of groundbreaking international findings on impaired interoception in depressive and suicidal persons.

Background: World Day of Suicide Prevention

The World Day of Suicide Prevention on 10 September regularly underlines suicide prevention as a matter of urgency and the importance of information on risk factors. Many suicides occur in the context of depressions, and over 700,000 individuals worldwide commit suicide every year. Advances in research, diagnostics and therapy are key factors to reducing this figure on a lasting basis.

Link to the paper:
https://onlinelibrary.wiley.com/doi/10.1111/sltb.70041

Information: You have thoughts of suicide? Telephone helplines offer free and anonymous support around the clock: (0800) 1110111 and (0800) 1110222. Counseling via e-mail or chat is another option. For further nationwide assistance services see the website of the German Association for Suicide Prevention.