Chronic suicidal ideation is common in clinical practice. However, little is known about cognitive factors contributing to the persistence of suicidal ideation. Results from previous studies suggest that comfort from suicidal thoughts (CST) and suicide-specific rumination (SSR) are two constructs in this field that warrant further investigation. The purpose of the present study was to investigate cognitive factors involved in the chronification of suicidal ideation by examining differences between patients with persistent suicidal ideation and patients with suicidal ideation, but without persistent suicidal ideation.

A total of N = 466 patients (65.0% female, 35.0% male; Mage = 35.93, SDage = 13.13, range: 18–79 years) who started therapy at an outpatient clinic participated in the study. They were asked to complete measures on suicidal thoughts and behavior, CST, SSR, depression, anxiety and stress. Of all patients included n = 103 (22.1%) reported being affected by persistent suicidal ideation.

Patients with persistent suicidal ideation reported higher levels of depression, anxiety and stress than patients without persistent suicide ideation or no suicidal ideation at all. Moreover, persistent suicide ideators exhibited significantly higher levels of SSR and CST compared to patients with non-persistent suicidal ideation. They also reported a higher number of lifetime suicide attempts and higher frequency of suicidal ideation. Finally, CST and SSR significantly determined the presence of persistent suicidal ideation, even when controlling for age, sex, depression, anxiety and stress.

The results hint that CST and SSR may contribute to the persistence of suicidal ideation.