Thinking About Suicide for a Long Time: A Scoping Review of Empirical Studies on Persistent Suicidal Ideation

INTRODUCTION: Persistent suicidal ideation (PSI) represents a clinically relevant phenomenon that remains insufficiently understood. The aim of this scoping review was to provide an overview of empirical studies investigating PSI, with a focus on definitions, operationalizations, and associations with indicators of mental health, suicidal behaviors, and treatment approaches. MATERIALS AND METHODS: Following established guidelines for conducting scoping reviews, a systematic search of the literature was conducted, and studies were screened according to predefined inclusion criteria. RESULTS: N = 44 articles reporting on n = 40 individual studies were included in this review. The results indicate that several empirical studies have addressed PSI, most commonly using longitudinal designs. However, the absence of a consistent conceptualization across studies led to diverse and heterogeneous operationalizations and partly contradictory findings, making synthesis difficult. DISCUSSION: A major limitation of this review lies in the inconsistent terminology across publications, which may have resulted in missed studies. Furthermore, case studies and theoretical works were excluded, narrowing the scope of the findings. CONCLUSION: The clinical relevance of PSI contrasts with the lack of empirical findings addressing its epidemiological and phenomenological characteristics. Future research should establish a common definition and operational criteria for PSI.