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Suicidal thoughts/acts and clinical correlates in patients with depressive disorders in Asians: results from the REAP-AD study

  • Seon-Cheol Park (a1), Min-Soo Lee (a2), Sang Woo Hahn (a3), Tian-Mei Si (a4), Shigenobu Kanba (a5), Mian-Yoon Chong (a6), Chee Kok Yoon (a7), Pichet Udomratn (a8), Adarsh Tripathi (a9), Norman Sartorius (a10), Naotaka Shinfuku (a11), Margarita M. Maramis (a12) and Yong Chon Park (a13) (a14)...

Abstract

Objective

Using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) study, we aimed to present the rates and clinical correlates of suicidal thoughts/acts in patients recruited from a total of 40 centres in 10 Asian countries/areas: China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Singapore, Taiwan, and Thailand.

Methods

Data from 1122 patients with depressive disorders in the REAP-AD study were used. The ICD-10 was employed to diagnose depressive episodes and recurrent depressive disorder. The presence or absence of suicidal thoughts/acts and profile of other depressive symptoms was established using the National Institute for Health and Clinical Excellence guidelines for depression. Country/area differences in rates of suicidal thoughts/acts were evaluated with the χ2 test. In addition, depressive symptom profiles, other clinical characteristics, and patterns of psychotropic drug prescription in depressed patients with and without suicidal thoughts/acts were compared using analysis of covariance for continuous variables and logistic regression analysis for discrete variables to adjust the effects of covariates.

Results

The rates of suicidal thoughts/acts in 10 countries/areas varied from 12.8% in Japan to 36.3% in China. Patients with suicidal thoughts/acts presented more persistent sadness (adjusted odds ratio [aOR]=2.64, p<0.001), loss of interest (aOR=2.33, p<0.001), fatigue (aOR=1.58, p<0.001), insomnia (aOR=1.74, p<0.001), poor concentration (aOR=1.88, p<0.001), low self-confidence (aOR=1.78, p<0.001), poor appetite (aOR=2.27, p<0.001), guilt/self-blame (aOR=3.03, p<0.001), and use of mood stabilisers (aOR=1.79, p<0.001) than those without suicidal thoughts/acts.

Conclusion

Suicidal thoughts/acts can indicate greater severity of depression, and are associated with a poorer response to antidepressants and increased burden of illness. Hence, suicidal thoughts/acts can provide a clinical index reflecting the clinical status of depressive disorders in Asians.

Copyright

Corresponding author

Yong Chon Park, Department of Psychiatry, Hanyang University Guri Hospital, 249-1, Gyomun-dong, Guri 471-701, Republic of Korea. Tel: +82 31 560 2273; Fax: +82 31 554 2599; E-mail: hypyc@hanyang.ac.kr

References

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