THE INTERPLAY OF DEPRESSION AND RUMINATION IN PREDICTING SUICIDAL IDEATION AMONG ADOLESCENT INPATIENTS

Jialing HUANG, Jian XIE, Lishu GAO, Jian LIN, Changyuan QIAO, Linqi ZHOU, Changchun HU

Psychiatry and Clinical Psychopharmacology - 2026;36(3):249-258

Department of Clinical Psychology, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou, China

 

Background: Adolescent inpatients with mood disorders are at elevated risk for suicide, with cognitive factors, especially rumination, playing a crucial role. This study investigates the impact of depression and rumination on suicidal ideation in this demographic, paying particular attention to the mediating role of rumination subtypes. It is hypothesized that brooding, a subtype of rumination, significantly mediates the relationship between depression and suicidal ideation. Methods: This cross-sectional study evaluated 157 adolescent inpatients diagnosed with mood disorders. Suicidal ideation was measured using the Beck Suicide Ideation Scale (Chinese Version). The Patient Health Questionnaire-9 was employed to assess the severity of depressive symptoms, while rumination levels were gauged using the Ruminative Responses Scale. Statistical analyses included correlation, regression, and mediation analyses via the PROCESS macro v4.1 (Model 4) for SPSS to explore relationships among these variables. Results: Adolescents with suicide attempts exhibited significantly higher levels of depression, rumination, and suicidal ideation compared to those without such a history. A positive correlation emerged between suicidal ideation and both depressive symptoms and rumination. Notably, depressive symptoms and the subtype of rumination were significant predictors of suicidal ideation. Furthermore, brooding was found to partially mediate the relationship between depressive symptoms and suicidal ideation, accounting for 43.7% of the total effect. Conclusion: This study underscores the pivotal roles of depression and rumination, particularly the brooding subtype, in predicting suicidal ideation among adolescent inpatients with mood disorders. The findings highlight the importance of targeting rumination in suicide prevention strategies. This research offers valuable insights into the cognitive mechanisms underlying adolescent suicidality and supports the development of interventions that specifically address emotion regulation and maladaptive thinking patterns in this high-risk group.