Mental Pain, Communication Difficulties, and Medically Serious Suicide Attempts: A Case-Control Study

Yossi Levi-Belz*, Yari Gvion, Netta Horesh, Tsvi Fischel, Ilan Treves, Evgenia Or, Orit Stein-Reisner, Mark Weiser, Haim Shem David, Alan Apter

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Medical severe suicide attempts (MSSA) are epidemiologically very similar to individuals who complete suicide. Thus the investigation of individuals who have made MSSAs may add to our understanding of the risk factors for completed suicide. The aim of this study was to assess the role of mental pain and communication difficulties in MSSA. A total of 336 subjects were divided into 4 groups: 78 meeting criteria for MSSA compared with116 subjects who made a medically non-serious suicide attempt (MNSSA), 47 psychiatric controls with no history of suicidal behavior, and 95 healthy controls. Mental pain variants (e.g., hopelessness), facets of communication difficulties (e.g., self-disclosure), as well as socio-demographic and clinical characteristics were assessed. The MSSA had significantly higher communication difficulties than the other 3 groups. Moreover, the interaction between mental pain and communication difficulties explained some of the variance in suicide lethality, above and beyond the contribution of each component alone. This report underlines the importance of mental pain for suicide attempts in general while difficulties in communication abilities play a critical role in differentiating MSSA from MNSSA. The co-existence of unbearable mental pain with difficulties in communication significantly enhances the risk for more lethal forms of suicidal behavior.

Original languageEnglish
Pages (from-to)74-87
Number of pages14
JournalArchives of Suicide Research
Issue number1
StatePublished - Jan 2014


  • medical lethality
  • mental pain
  • schizoid tendencies
  • self-disclosure


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