Psychopathological predictors of suicide in patients with major depression during a 5-year follow-up

Schneider, B.; Philipp, Michael; Müller, Matthias J.

doi:10.1016/s0924-9338(01)00579-x

Cited by 85 publications

(66 citation statements)

References 29 publications

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“…This study design takes maximum advantage of the unique strengths of VA data resources and has distinct advantages when studying rare outcomes, such as suicide. 34,35 The study observation period for our cohort began on April 1, 1999, and extended until the end of fiscal year 2004 (September 30, 2004). Observations from 1997 to 1999 were not included in the study cohort, because of a lack of national pharmacy data prior to 1999.…”

Section: Methodsmentioning

confidence: 99%

Suicide Mortality Among Individuals Receiving Treatment for Depression in the Veterans Affairs Health System: Associations with Patient and Treatment Setting Characteristics

et al. 2007

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Zivin et al. | Peer Reviewed | Research and Practice | 2193 RESEARCH AND PRACTICE  Objectives. We sought to report clinical and demographic factors associated with suicide among depressed veterans in an attempt to determine what characteristics identified depressed veterans at high risk for suicide.Methods. We used longitudinal, nationally representative data (1999)(2000)(2001)(2002)(2003)(2004)) to determine suicide rates among depressed veterans, estimating time until suicide using Cox proportional hazards regression models.Results. Of 807694 veterans meeting study criteria, 1683 (0.21%) committed suicide during follow-up. Increased suicide risks were observed among male, younger, and non-Hispanic White patients. Veterans without service-connected disabilities, with inpatient psychiatric hospitalizations in the year prior to their qualifying depression diagnosis, with comorbid substance use, and living in the southern or western United States were also at higher risk. Posttraumatic stress disorder (PTSD) with comorbid depression was associated with lower suicide rates, and younger depressed veterans with PTSD had a higher suicide rate than did older depressed veterans with PTSD.Conclusions. Unlike the general population, older and younger veterans are more prone to suicide than are middle-aged veterans. Future research should examine the relationship between depression, PTSD, health service use, and suicide risks among veterans. (Am J Public Health.

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Section: Methodsmentioning

confidence: 99%

Suicide Mortality Among Individuals Receiving Treatment for Depression in the Veterans Affairs Health System: Associations with Patient and Treatment Setting Characteristics

et al. 2007

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“…Other studies confirmed the risk of suicide to be particularly high in hospitalized depressed patients (4)(5)(6). Profound hopelessness, hypochondriacal ruminations or delusions, and thoughts of suicide or self-harm during depression predict future suicide (7).…”

mentioning

confidence: 87%

Relief of Expressed Suicidal Intent by ECT: A Consortium for Research in ECT Study

Kellner¹,

Fink²,

Knapp³

et al. 2005

AJP

282

164

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Objective-This study assessed the incidence, severity, and course of expressed suicidal intent in depressed patients who were treated with ECT. The data are from the first phase of an ongoing, collaborative multicenter study, the overall aim of which was to compare continuation ECT with pharmacotherapy in the prevention of relapse after a successful course of ECT.Method-Suicidal intent, as expressed by patients during an interview, was scored at baseline and before each ECT session with item 3 on the 24-item Hamilton Depression Rating Scale in 444 patients with unipolar depression.Results-One hundred thirty-one patients (29.5%) reported suicidal thoughts and acts (score of 3 or 4) at baseline. Scores decreased to 0 after 1 week (three ECT sessions) in 38.2% of the patients, after 2 weeks (six ECT sessions) in 61.1%, and in 80.9% at the end of the course of treatment.Conclusions-Expressed suicidal intent in depressed patients was rapidly relieved with ECT. Evidence-based treatment algorithms for major depressive mood disorders should include dichotomization according to suicide risk, as assessed by interview. For patients at risk, ECT should be considered earlier than at its conventional "last resort" position.Suicide and suicide attempts are risks of the major psychiatric illnesses, with mortality rates markedly higher than for the general population (1). A lifetime risk of 15% for suicide was the conclusion of a meta-analysis of hospitalized patients by Guze and Robins (2). A reanalysis of studies of suicide in affective illness in three groups of patients-outpatients, inpatients, and suicidal patients-found a risk of those ever hospitalized of 8.6% (3). Other studies confirmed the risk of suicide to be particularly high in hospitalized depressed patients (4-6). Profound hopelessness, hypochondriacal ruminations or delusions, and thoughts of suicide or self-harm during depression predict future suicide (7).Antidepressant medications are the principal agents used to treat affective disorders today. Their impact on suicide risk is not well defined, however, and they are generally viewed as less effective than ECT in relieving depression and suicidal thoughts. Hordern et al. (8) reported no suicides at the 6-month follow-up in 34 women treated with ECT but found two in the 84 patients treated with antidepressants (2.4%). Avery and Winokur (9) suicidal behavior in the 6 months following the treatment of depression in 519 patients. Suicide attempts were recorded in 0.8% of the ECT patients compared to 4.2% of those who had received "adequate" and 7% "inadequate" antidepressant medication treatment. Khan et al. (10) found antidepressant drugs to be no more effective than placebo in reducing suicide rates in seriously ill depressed patients.The experience with ECT is also unclear. A comparison of the frequency of suicides in different decades found decreased rates when ECT was the dominant treatment for mental illness (11). An examination of the records of 1,397 completed suicides in Finland within a 12-m...

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“…This confirms findings from a psychological autopsy study by Isometsa et al in which 79% of the suicides studied occurred during depressed or mixed states. 37 In studies with mixed samples (patients with bipolar disorder and major depression), three prospective studies found that suicidal ideation predicted completed suicide, [38][39][40] but others found that suicidal ideation was not a predictor, despite being more prominent in patients with previous attempts, 41 Oquendo et al suggests that measures of suicidal ideation can be more useful to identify patients at higher risk of suicide behavior when integrated into a "pessimism factor" which encompasses measures of subjective depression, reasons for living and hopelessness rather than a single predictor of suicidal behavior. 18 In conclusion, although suicide ideation has been understudied until recently, it can be an important risk factor for suicide attempts.…”

Section: Stress-diathesis Modelmentioning

confidence: 99%

Suicidal ideation and suicide attempts in bipolar disorder type I: an update for the clinician

Abreu

Lafer

Baca‐García

et al. 2009

Rev. Bras. Psiquiatr.

101

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Psychopathological predictors of suicide in patients with major depression during a 5-year follow-up

Abstract: These symptoms seem to be helpful early predictors for the risk of suicide during the further course of illness. This should be taken into account for suicide prevention in the course of major depression.

Cited by 85 publications

References 29 publications

Suicide Mortality Among Individuals Receiving Treatment for Depression in the Veterans Affairs Health System: Associations with Patient and Treatment Setting Characteristics

Suicide Mortality Among Individuals Receiving Treatment for Depression in the Veterans Affairs Health System: Associations with Patient and Treatment Setting Characteristics

Relief of Expressed Suicidal Intent by ECT: A Consortium for Research in ECT Study

Suicidal ideation and suicide attempts in bipolar disorder type I: an update for the clinician

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