From “The Interpersonal Theory of Suicide” to “The Interpersonal Trust”: an unexpected and effective resource to mitigate economic crisis-related suicide risk in times of Covid-19?

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Alessandra Costanza
Andrea Amerio
Andrea Aguglia
Gianluca Serafini
Mario Amore
Elena Macchiarulo
Francesco Branca
Roberto Merli


Suicide, Suicide behavior, Suicide attempt, Suicidal ideation, COVID-19, Interpersonal Theory of Suicide, Interpersonal Trust, Economic crisis, Financial stressors, Protective factors, Resilience, Mental health


Suicide risk and resilience strategies during the different phases of the COVID-19 pandemic are of great interest to researchers. At the pandemic onset, a dramatic suicides exacerbation was feared. Some authoritative authors warned the scientific and clinical community about this risk by pointing out that especially psychiatric, psychological, and social factors could interact with each other to create a vicious cycle. While worldwide case-reports and studies conducted at emergency departments did indeed find an increase in suicidal behavior, recent systematic reviews, meta-analyses, and time-series analyses could not confirm this for the first COVID-19 wave. Instead, it appears that the increased suicide risk outlasted the acute phase of the pandemic and thus affected people more during the pandemic following phases. One possible reason for this phenomenon may be a persistent state of insecurity regarding the economic crisis evolution with serious financial stressors in terms of income decrease, unemployment, repaying debts difficulty, home loss, one’s social status derive, social hierarchy drop, and poverty. During the COVID-19 first wave, with particular regard to vulnerable populations, one of the postulated theories unifying different risk factors under a single frame was the "Interpersonal Theory of Suicide". Conversely, the “Interpersonal Trust” theory emerged as a protective factor even during an economic crisis. In a possible mirroring of the two theories, it seems to be feasible to find common themes between them and, above all, to gain relevant insights to devise effective prevention and supportive strategies for dealing with suicide risk challenges that COVID-19 will continue to pose in the foreseeable future. (


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