Death anxiety and death-related depression in opioid use disorder: relationships with suicidal ideation, impulsivity, and psychological resilience

Creative Commons License

Kurt M., Taşdemir A., Gök M.

BMC PSYCHIATRY, vol.26, pp.682, 2026 (SCI-Expanded, Scopus)

  • Publication Type: Article / Article
  • Volume: 26
  • Publication Date: 2026
  • Doi Number: 10.1186/s12888-026-08325-1
  • Journal Name: BMC PSYCHIATRY
  • Journal Indexes: Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Scopus, Science Citation Index Expanded (SCI-EXPANDED), EMBASE, MEDLINE, Psycinfo, Directory of Open Access Journals
  • Page Numbers: pp.682
  • Open Archive Collection: AVESIS Open Access Collection
  • Karadeniz Technical University Affiliated: Yes

Abstract

Abstract

Background Opioid use disorder (OUD) is associated with elevated suicide and impulsivity risks, yet the underlying

existential vulnerabilities remain underexplored. This study aimed to examine death anxiety and death-related

depression as potential mechanisms associated with suicidal ideation and impulsivity in OUD, and to evaluate the

protective role of psychological resilience.

Methods Participants included 86 individuals with OUD in remission (under buprenorphine/naloxone treatment)

and 86 healthy controls. Self-report measures assessed death anxiety, death-related depression, suicidal ideation,

impulsivity, and psychological resilience. Data were analyzed using group comparisons and hierarchical regression

models.

Results While death anxiety did not significantly differ between groups (p = 0.153), the OUD group showed

significantly higher death-related depression, suicidal ideation, and impulsivity, alongside lower resilience (p < 0.003).

Hierarchical regression analyses revealed that death-related depression positively predicted suicidal ideation (β =

0.278, p = 0.007), whereas psychological resilience demonstrated a significant negative association (β = -0.296, p =

0.002). In the impulsivity model, psychological resilience emerged as the only significant predictor (β = -0.482, p <

0.001).

Conclusions Findings suggest that death-related depression, reflecting existential hopelessness rather than threatbased

anxiety, represents an overlooked psychological vulnerability closely linked to suicidal ideation in OUD.

Psychological resilience acts as a critical protective factor against both suicidal ideation and impulsivity. Interventions

targeting meaning-making and resilience may be vital for mitigating suicide risk in this population.

Keywords Opioid use disorder, Death anxiety, Death depression, Suicidal ideation, Psychological resilience,

Impulsivity