Aspects of Additional Psychiatric Disorders in Severe Depression/Melancholia: A Comparison between Suicides and Controls and General Pattern

Abstract

Objective: Additional and comorbid diagnoses are common among suicide victims with major depressive disorder (MDD) and have been shown to increase the suicide risk. The aim of the present study was first, to investigate whether patients with severe depression/melancholia who had died by suicide showed more additional psychiatric disorders than a matched control group. Second, general rates of comorbid and additional diagnoses in the total group of patients were estimated and compared with literature on MDD. Method: A blind record evaluation was performed on 100 suicide victims with severe depression/melancholia (MDD with melancholic and/or psychotic features: MDD-M/P) and matched controls admitted to the Department of Psychiatry, Lund, Sweden between 1956 and 1969 and monitored to 2010. Diagnoses in addition to severe depression were noted. Results: Less than half of both the suicides and controls had just one psychiatric disorder (47% in the suicide and 46% in the control group). The average number of diagnoses was 1.80 and 1.82, respectively. Additional diagnoses were not related to an increased suicide risk. Anxiety was the most common diagnosis. Occurrence of suspected schizophrenia/schizotypal or additional obsessive-compulsive symptoms were more common than expected, but alcohol use disorders did not appear very frequent. Conclusions: The known increased risk of suicide in MDD with comorbid/additional diagnoses does not seem to apply to persons with MDD-M/P (major depressive disorder-depression/Melancholia). Some diagnoses, such as schizophrenia/schizotypal disorders, were more frequent than expected, which is discussed, and a genetic overlap with MDD-M/P is proposed.

Pattern of suicide behaviour among the mentally ill in a Tertiary Hospital in South-South Nigeria

“…Contrary to expectations, the comorbidity of suicide victims and controls was the same. Therefore, comorbidity does not seem to raise the risk in MDD-M/P, contrary to the findings of Heu et al (2018) on depression and suicide risk. This suggests that the significant risk of suicide associated with MDD-M/P may not be exacerbated by co-occurring conditions.…”

Suicide Risk and Mental Disorders

“…Furthermore, comorbid disorders, are associated with a high suicide risk [ 1 , 13 , 14 ]. One paper in the present issue explores comorbid disorders and suicide risk in severe depression/melancholia (major depressive disorder with melancholic and/or psychotic features-MDD-M/P) [ 15 ]. Hospitalized patients with MDD-M/P who later died by suicide were compared with matched controls who died a natural death (or in a few cases survived) in a long-term follow-up of almost 60 years.…”

Sex-Specific Association of Alcohol Use Disorder With Suicide Mortality

“…Our search strategy initially yielded 29 533 records; after removal of duplicates, 16 347 remained ( Figure 1 ). After abstract screening and full-text review, 19 studies 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 identified from the search strategy and 5 studies 53 , 54 , 55 , 56 , 57 identified from manual reviews were included for analysis, for a total of 24 studies with 37 870 699 participants (59.7% male and 40.3% female) ( Table 2 ). Participants ranged in age from 15 years to 65 years or older.…”

“…Most studies included participants from the general population or from a nationally representative sample, followed by studies of a patient population, 34,37,38,40,52,53,57 active 47 or veteran 35,55 military personnel, individuals experiencing homelessness, 54 deceased individuals, 51 and health professionals. 45 The age range of the individuals in the studies varied, with 4 studies 39,47,49,57 limited…”