To examine the predictors of suicidal ideation and self-harm in patients diagnosed with a depressive episode or an adjustment disorder, and to examine any difference in these predictors between the two diagnostic categories.

Patients referred to the liaison psychiatry services at two Dublin hospitals and diagnosed with either a depressive episode or an adjustment disorder were recruited to this study. They were interviewed at time of diagnosis, and again after six months, with a number of validated instruments to examine levels of suicidality or self-harm and their relationship to depressive symptoms, life events, social functioning and personality factors.

300 patients were recruited to the study, 154 of whom had a diagnosis of an adjustment disorder and the remainder diagnosed with a depressive episode. On univariate analysis there was no significant difference in the rates of suicidal ideation between the diagnoses of depressive episode and adjustment disorder. On logistic regression there were no significant predictors of suicidal ideation in adjustment disorder. A single marital status and low levels of social support were more predictive of suicidality in the subgroup with a diagnosis of depression.

There has been little prior research into the predictors of suicidal behaviour in patients with diagnoses of depression and adjustment disorders. Our finding that social support and marital status are protective against suicidality in this population is in keeping with the literature. The absence of any significant contribution of the severity of depressive symptoms to suicidality was unexpected.