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Suicidal ideation and attempts among psychiatric patients with major depressive disorder.
J Clin Psychiatry. 2003 Sep; 64(9):1094-100.JC

Abstract

BACKGROUND

Few studies have investigated risk factors for suicidal ideation and attempts, or possible variations in them, among representative samples of psychiatric patients with major depressive disorder.

METHOD

As part of the Vantaa Depression Study in Vantaa, Finland, 269 patients with DSM-IV major depressive disorder (MDD), diagnosed by interview using semistructured World Health Organization Schedules for Clinical Assessment in Neuropsychiatry, version 2.0, and Structured Clinical Interview for DSM-III-R Personality Disorders, were thoroughly investigated. Information was gathered on patients' levels of depression, anxiety, hopelessness, perceived social support, social and occupational functioning, and alcohol use. Suicidal behavior was assessed by interviews, including the Scale for Suicidal Ideation, and by information from psychiatric records. Data were gathered from Feb. 1, 1997, to May 31, 1998.

RESULTS

During the current MDD episode, 58% of all patients had experienced suicidal ideation; among the 15% of the total who had attempted suicide, almost all (95%) had also had suicidal ideation. In nominal regression models predicting suicidal ideation, hopelessness, alcohol dependence or abuse, low level of social and occupational functioning, and poor perceived social support were found to be significant (p < .05) independent risk factors. High severity of depression and current alcohol dependence or abuse in particular, but also younger age and low level of social and occupational functioning, predicted suicide attempt.

CONCLUSION

Suicidal ideation is prevalent and appears to be a precondition for suicide attempts among psychiatric patients with MDD. The risk factors for suicidal ideation and attempts locate in several clinical and psychosocial domains. While these risk factors largely overlap, the overall level of psychopathology of suicide attempters is higher compared with that in patients with ideation, and substance use disorders and severity of depression may be of particular importance in predicting suicide attempts.

Authors+Show Affiliations

Sokero TP
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Melartin TK
No affiliation info available
Rytsälä HJ
No affiliation info available
Leskelä US
No affiliation info available
Lestelä-Mielonen PS
No affiliation info available
Isometsä ET
No affiliation info available

MeSH

AdultAlcoholismCohort StudiesComorbidityDepressive Disorder, MajorDiagnostic and Statistical Manual of Mental DisordersFemaleFinlandHumansMaleMental DisordersMiddle AgedPersonality AssessmentPersonality InventoryPsychometricsRetrospective StudiesRisk FactorsSuicide, Attempted

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14628986

Citation

Sokero, T Petteri, et al. "Suicidal Ideation and Attempts Among Psychiatric Patients With Major Depressive Disorder." The Journal of Clinical Psychiatry, vol. 64, no. 9, 2003, pp. 1094-100.
Sokero TP, Melartin TK, Rytsälä HJ, et al. Suicidal ideation and attempts among psychiatric patients with major depressive disorder. J Clin Psychiatry. 2003;64(9):1094-100.
Sokero, T. P., Melartin, T. K., Rytsälä, H. J., Leskelä, U. S., Lestelä-Mielonen, P. S., & Isometsä, E. T. (2003). Suicidal ideation and attempts among psychiatric patients with major depressive disorder. The Journal of Clinical Psychiatry, 64(9), 1094-100.
Sokero TP, et al. Suicidal Ideation and Attempts Among Psychiatric Patients With Major Depressive Disorder. J Clin Psychiatry. 2003;64(9):1094-100. PubMed PMID: 14628986.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Suicidal ideation and attempts among psychiatric patients with major depressive disorder. AU - Sokero,T Petteri, AU - Melartin,Tarja K, AU - Rytsälä,Heikki J, AU - Leskelä,Ulla S, AU - Lestelä-Mielonen,Paula S, AU - Isometsä,Erkki T, PY - 2003/11/25/pubmed PY - 2004/2/18/medline PY - 2003/11/25/entrez SP - 1094 EP - 100 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 64 IS - 9 N2 - BACKGROUND: Few studies have investigated risk factors for suicidal ideation and attempts, or possible variations in them, among representative samples of psychiatric patients with major depressive disorder. METHOD: As part of the Vantaa Depression Study in Vantaa, Finland, 269 patients with DSM-IV major depressive disorder (MDD), diagnosed by interview using semistructured World Health Organization Schedules for Clinical Assessment in Neuropsychiatry, version 2.0, and Structured Clinical Interview for DSM-III-R Personality Disorders, were thoroughly investigated. Information was gathered on patients' levels of depression, anxiety, hopelessness, perceived social support, social and occupational functioning, and alcohol use. Suicidal behavior was assessed by interviews, including the Scale for Suicidal Ideation, and by information from psychiatric records. Data were gathered from Feb. 1, 1997, to May 31, 1998. RESULTS: During the current MDD episode, 58% of all patients had experienced suicidal ideation; among the 15% of the total who had attempted suicide, almost all (95%) had also had suicidal ideation. In nominal regression models predicting suicidal ideation, hopelessness, alcohol dependence or abuse, low level of social and occupational functioning, and poor perceived social support were found to be significant (p < .05) independent risk factors. High severity of depression and current alcohol dependence or abuse in particular, but also younger age and low level of social and occupational functioning, predicted suicide attempt. CONCLUSION: Suicidal ideation is prevalent and appears to be a precondition for suicide attempts among psychiatric patients with MDD. The risk factors for suicidal ideation and attempts locate in several clinical and psychosocial domains. While these risk factors largely overlap, the overall level of psychopathology of suicide attempters is higher compared with that in patients with ideation, and substance use disorders and severity of depression may be of particular importance in predicting suicide attempts. SN - 0160-6689 UR - https://www.unboundmedicine.com/medline/citation/14628986/Suicidal_ideation_and_attempts_among_psychiatric_patients_with_major_depressive_disorder_ DB - PRIME DP - Unbound Medicine ER -