Comparison of Metacognition in Depressed Suicide Attempters and Healthy Controls: A Case–Control Study in a Tertiary Care Hospital

and reliable biological markers of risk remain elusive. 2 Understanding the mechanisms underlying suicidal thoughts and behaviors (STBs) is crucial for developing targeted prevention strategies and monitoring their effectiveness.In the past decade, and especially the last 5 years, neuroimaging studies on the brain circuits linked to STBs have IntroductIonDepression is a common mental health condition marked by ongoing sadness, hopelessness, and sometimes suicidal thoughts or actions.Recent research highlights the importance of metacognition, the awareness and control of one's thoughts and beliefs, in understanding suicidal tendencies among depressed individuals.Maladaptive metacognitive patterns may worsen depressive symptoms and increase the risk of suicidal ideation.However, there is limited understanding of how metacognition varies among depressed individuals with different levels of suicidality.According to the survey findings, approximately 5% of individuals in India experience depression, with close to 1% of the population reporting a high risk of suicide. 1 Studies emphasize that suicides rank as the leading cause of death among Indian youths aged 15-29 and 15-39, ranking second and third globally in these age-groups, respectively.Reports on the overall disease, injury, and risk factor trends in India from 1990 to 2016 revealed a >40% increase in suicide deaths over 26 years.It is important to recognize that individuals contemplating suicide are often overwhelmed by intense emotions and may perceive death as the only escape, disregarding the fact that suicide is a permanent resolution to temporary problems.Currently, nonbiological risk factors for suicide have limited predictive value,