Who are the patients who deny suicidal intent? Exploring patients' characteristics associated with self-disclosure and denial of suicidal intent

Sarah Bloch-Elkouby, Sigal Zilcha-Mano, Megan L. Rogers, Ji Yoon Park, Katherine Manlongat, Mia Krumerman, Igor Galynker

Research output: Contribution to journalArticlepeer-review


Background: Patients' non-disclosure of suicidal ideation and intent concealment represent a major obstacle to the effective assessment of suicide risk and to the delivery of suicide prevention treatments. The present study aimed to investigate this phenomenon and to assess (1) if outpatient psychiatric patients are more or less likely to disclose intent to mental health clinicians in the context of psychiatric/psychological treatment than they are to in the context of research interviews with non-clinicians; and (2) if certain demographic, trait-like, and state-like characteristics may predict such disclosure differences. Methods: A total of 780 psychiatric outpatient participants aged 18 to 84 and 193 clinician participants aged 25 to 54 were included in the study. The proportion of patients who disclosed to clinicians only, to research assistants (RAs) only, to both, and to none, was compared using a z-test. Univariate analyses were used to compare the participants' variables across disclosure groups, and significant individual predictors were included in multilevel regression analyses. Results: Participants were more significantly more likely to disclose to RAs (10.4%) than to clinicians (5.6%), p < 0.001. Neuroticism and trait anxiety predicted disclosure to RAs vs no disclosure; low extraversion predicted disclosure to clinician versus no disclosure; and extraversion and trait anxiety predicted disclosure to RAs versus to clinicians. Discussion: Patients' disclosure patterns, the personality variables predicting them, and their clinical implications were discussed in the context of the extant literature on patients' reasons for concealing suicidal ideation and intent.

Original languageEnglish
Number of pages12
JournalActa Psychiatrica Scandinavica
Issue number2
Early online date19 Oct 2022
StatePublished - Feb 2023

Bibliographical note

Funding Information:
This study was supported by the American Foundation for Suicide Prevention (AFSP) focus grant #RFA‐1‐015‐14. The content is solely the responsibility of the authors and does not necessarily represent the official views of the American Foundation for Suicide Prevention. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.


  • concealment
  • nondisclosure
  • suicidal ideation
  • suicidal intent disclosure

ASJC Scopus subject areas

  • Psychiatry and Mental health


Dive into the research topics of 'Who are the patients who deny suicidal intent? Exploring patients' characteristics associated with self-disclosure and denial of suicidal intent'. Together they form a unique fingerprint.

Cite this