Major depressive disorder is one of the most commonly diagnosed mental health disorders. Those who suffer from depression are also at an increased risk for disorders such as substance use disorder and anxiety. In addition, those with depression are also at a higher risk for suicidal ideation. While depression is often associated with suicidal ideation, there are many other factors that can also contribute to the rise of suicidal thoughts and attempts. However, major depressive disorder contributes to the likelihood of suicidal ideation. This is because one of the characteristics of depression is the presence of negative affect and hopelessness. Hopelessness has been shown to act as a predictor of suicidal ideation. In an effort to better understand the factors associated with suicidal ideation in those with depression, Madhukar H. Trivedi of the Department of Psychiatry at the University of Texas Southwestern Medical Center in Dallas recently conducted a study with this aim. The study used information from 4,000 patients who had received treatment on an outpatient basis for major depressive disorder. The researchers used the data to analyze the symptoms reported by the patients and determine what additional factors had led to suicidal ideation. Included in the consideration were variables such as gender, socio-demographic factors and the presence of other mental health issues. The researchers particularly considered the role of anxiety disorders, including specific disorders like agoraphobia, panic, social anxiety and generalized anxiety, as well as posttraumatic stress disorder and substance use disorders. The results of the analysis indicated that close to 15 percent of those with depression also experienced suicidal ideation. In addition, the researchers were surprised to find that almost 35 percent reported that they believed that life was not worth living. The analysis also showed that certain other factors influenced whether suicidal ideation was present. The researchers found that unmarried and unemployed patients were more likely to experience suicidal ideation when compared to their married, employed counterparts. Men were also more likely to experience suicidal ideation compared with women. A history of suicide attempts also increased the likelihood that suicidal ideation would be present in the patient. However, the analysis did not identify any significant association between the number of instances that major depressive episodes were reported and the likelihood that suicidal ideation was present in the patient. When psychological risk factors were evaluated, fear, rumination, anger, worry, GAD, irritability and agoraphobia were the variables most likely to increase the likelihood of suicidal ideation. While some of the associations were not particularly strong, researchers noted a particular association between GAD and agoraphobia as predictors for suicidal ideation. The findings were published in a recent issue of the Canadian Journal of Psychiatry.