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Journal published by the Hellenic
Psychiatric Association


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According to Shneidman’s theory, mental pain or "psychache", which refers to an endopsychicpainful experience consisted of excessively felt negative feelings, is a key component to theunderstanding of suicidal behaviour, as to its psychological features. Shneidman himself supportedthat ‘suicide is caused by psychache’, more precisely suicide occurs when a person canno longer tolerate this pain. Findings of previous studies have shown that mental pain is an independentpredictive factor for suicidal behaviour. In the present study we evaluated the psychometric propertiesof the Greek version of the Mental Pain Scale (MPS) and the Tolerance for Mental Pain Scale (TMPS) ina non clinical sample consisted of 112 participants (73 female and 39 male). Moreover, we explore therelationships between mental pain, depression, and suicide risk and for the first time the effect of thetolerance for mental pain on depression and suicide risk. We hypothesized that both the level of mentalpain and the degree of tolerance for mental pain would predict suicide risk, independently of the levelof depression. Both MPS and TMPS appear to have satisfactory to high levels of internal consistency, testretestreliability, and concurrent validity. Suicide risk was correlated to mental pain, tolerance for mentalpain, and depression. Multiple regression analysis showed that mental pain and tolerance for mentalpain have a significant contribution to suicide risk, independently of depression, confirming our hypothesis.Using an additional multivariate regression with the factors extracted from MPS and TMPS as independentvariables, we found that especially ‘loss of control’ of mental pain and the ability to ‘contain thepain’ contribute uniquely to suicide risk. Our findings offer support to the hypothesis that mental painis a clinical entity distinct from depression with a specific and important contribution to the suicide risk.Depression alone is not enough to cause suicide. The mental pain construct, although related to depression,could shed light on the comprehension of the human experience that leads to suicide. Relievingmental pain may constitute a distinct and important treatment goal, along with the remission of depressionand despair, so that the person can maintain control and contain all the distressing events that comprisethe painful experience. Both MPS and TMPS appear to be valid and reliable tools for the assessmentof mental pain and its tolerance, respectively. They could also be employed in further investigation onthe role of specific aspects of the mental pain experience in suicidal behaviours.

Key words: Mental pain, psychache, suicide risk, tolerance of mental pain, depression

A. Soumani, D. Damigos, P. Oulis, V. Masdrakis, D. Ploumpidis, V. Mavreas, G. Konstantakopoulos (page 330) - Full article