The social and economic impact of mood disorders and suicide is extremely high. In depression, suicide is included among the cognitive disturbances, together with guilt, paranoid and obsessive-compulsive symptoms, depersonalization/derealization and agitation [1,2]. The aim of this report is to study a sample of depressed patients with bipolar disorder or major depressive disorder, to evaluate the level of impulsivity and dissociation in a context of a suicidal plan.

Twenty inpatients with suicidal plan were assessed with: the SCID-P for Axis I diagnosis, SCI-DER, DSS, HRSD, HAS, YMRS, GSR. We conducted a systematic literature review (PubMed, Embase, PsychInfo) using the key terms “depression”, “suicide”, “suicidal plan”, “depersonalization”, “derealization” AND “dissociation”.

An independent sample T-Test analysis suggested that the patient with high sucidal plan present significant highter score at SCI-DER TOT (P = 0.015), DSS TOT (P = 0.037), BIS-11 motor perseveration factor (P = 0.023) and inversely significant HAS TOT (P = .029).

It's suggestive that when are lost the boundaries of the self, the clarity of suicidal's purpose reduces the levels of anxiety and suicide appears the only way to achieve the liberation of the suffering of depression. Methodological limitations, clinical implications and suggestions for future research directions are considered.

The authors have not supplied their declaration of competing interest.