In fact, two systematic meta-analyses have found weak associations between suicidal ideation and suicide. The first found that a modest association between suicide and suicidal ideation expressed by psychiatric inpatients might have been because of publication bias (7). Suicidal ideation did not independently predict inpatient suicide when depressed mood and previous suicide attempts were also considered (8). The second study found that suicidal ideas expressed in the hospital were weakly associated with suicide after discharge (9). We agree that there is a need to clarify the definitions of suicidal ideation and behavior. However, the presence of suicidal ideation, in the absence of a suicide attempt, has not been firmly established as a risk factor for suicide.