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A comparison of the clinical characteristics of women with recurrent major depression with and without suicidal symptomatology

  • B. Bi (a1), X. Xiao (a1), H. Zhang (a1), J. Gao (a2), M. Tao (a3), H. Niu (a4), Y. Wang (a5), Q. Wang (a6), C. Chen (a7), N. Sun (a8), K. Li (a9), J. Fu (a10), Z. Gan (a11), W. Sang (a12), G. Zhang (a13), L. Yang (a14), T. Tian (a15), Q. Li (a16), Q. Yang (a17), L. Sun (a18), Ying Li (a19), H. Rong (a20), C. Guan (a21), X. Zhao (a22), D. Ye (a23), Y. Zhang (a24), Z. Ma (a25), H. Li (a26), K. He (a27), J. Chen (a28), Y. Cai (a29), C. Zhou (a30), Y. Luo (a31), S. Wang (a32), S. Gao (a33), J. Liu (a34), L. Guo (a35), J. Guan (a36), Z. Kang (a37), D. Di (a38), Yajuan Li (a39), S. Shi (a29), Yihan Li (a40), Y. Chen (a41), J. Flint (a40), K. Kendler (a42) and Y. Liu (a1)...

Abstract

Background

The relationship between recurrent major depression (MD) in women and suicidality is complex. We investigated the extent to which patients who suffered with various forms of suicidal symptomatology can be distinguished from those subjects without such symptoms.

Method

We examined the clinical features of the worst episode in 1970 Han Chinese women with recurrent DSM-IV MD between the ages of 30 and 60 years from across China. Student's t tests, and logistic and multiple logistic regression models were used to determine the association between suicidality and other clinical features of MD.

Results

Suicidal symptomatology is significantly associated with a more severe form of MD, as indexed by both the number of episodes and number of MD symptoms. Patients reporting suicidal thoughts, plans or attempts experienced a significantly greater number of stressful life events. The depressive symptom most strongly associated with lifetime suicide attempt was feelings of worthlessness (odds ratio 4.25, 95% confidence interval 2.9–6.3). Excessive guilt, diminished concentration and impaired decision-making were also significantly associated with a suicide attempt.

Conclusions

This study contributes to the existing literature on risk factors for suicidal symptomatology in depressed women. Identifying specific depressive symptoms and co-morbid psychiatric disorders may help improve the clinical assessment of suicide risk in depressed patients. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicide.

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Copyright

The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence . The written permission of Cambridge University Press must be obtained for commercial re-use.

Corresponding author

*Address for correspondence: Y. Liu, Department of Psychiatry, The First Hospital of China Medical University, No. 155 Nanjing North Street, He Ping District, Shenyang, 110001, People's Republic of China. (Email: Liuyingpsy@yahoo.com.cn) [Y.L.](Email: jf@well.ox.ac.uk) [J.F.]

References

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APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn.American Psychiatric Association: Washington, DC.
Bedi, S, Nelson, EC, Lynskey, MT, McCutcheon, VV, Heath, AC, Madden, PA, Martin, NG (2011). Risk for suicidal thoughts and behavior after childhood sexual abuse in women and men. Suicide and Life-Threatening Behavior 41, 406415.
Boden, JM, Fergusson, DM, Horwood, LJ (2007). Anxiety disorders and suicidal behaviours in adolescence and young adulthood: findings from a longitudinal study. Psychological Medicine 37, 431440.
Bolton, JM, Belik, SL, Enns, MW, Cox, BJ, Sareen, J (2008 a). Exploring the correlates of suicide attempts among individuals with major depressive disorder: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 69, 11391149.
Bolton, JM, Cox, BJ, Afifi, TO, Enns, MW, Bienvenu, OJ, Sareen, J (2008 b). Anxiety disorders and risk for suicide attempts: findings from the Baltimore Epidemiologic Catchment area follow-up study. Depression and Anxiety 25, 477481.
Bolton, JM, Pagura, J, Enns, MW, Grant, B, Sareen, J (2010). A population-based longitudinal study of risk factors for suicide attempts in major depressive disorder. Journal of Psychiatric Research 44, 817826.
Brådvik, L (2003). Suicide after suicide attempt in severe depression: a long-term follow-up. Suicide and Life-Threatening Behavior 33, 381388.
Brown, LA, Gaudiano, BA, Miller, IW (2010). The impact of panic–agoraphobic comorbidity on suicidality in hospitalized patients with major depression. Depression and Anxiety 27, 310315.
Bulik, CM, Carpenter, LL, Kupfer, DJ, Frank, E (1990). Features associated with suicide attempts in recurrent major depression. Journal of Affective Disorders 18, 2937.
Claassen, CA, Trivedi, MH, Rush, AJ, Husain, MM, Zisook, S, Young, E, Leuchter, A, Wisniewski, SR, Balasubramani, GK, Alpert, J (2007). Clinical differences among depressed patients with and without a history of suicide attempts: findings from the STAR*D trial. Journal of Affective Disorders 97, 7784.
Corbitt, EM, Malone, KM, Haas, GL, Mann, JJ (1996). Suicidal behavior in patients with major depression and comorbid personality disorders. Journal of Affective Disorders 39, 6172.
Cox, JL, Holden, JM, Sagovsky, R (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry 150, 782786.
Diaconu, G, Turecki, G (2007). Panic disorder and suicidality: is comorbidity with depression the key? Journal of Affective Disorders 104, 203209.
Eysenck, HJ, Eysenck, SBG (1975). Manual of the Eysenck Personality Questionnaire. Educational and Industrial Testing Service: San Diego, CA.
Harris, EC, Barraclough, B (1997). Suicide as an outcome for mental disorders. A meta-analysis. British Journal of Psychiatry 170, 205228.
Hoyer, EH, Mortensen, PB, Olesen, AV (2000). Mortality and causes of death in a total national sample of patients with affective disorders admitted for the first time between 1973 and 1993. British Journal of Psychiatry 176, 7682.
Katz, C, Yaseen, ZS, Mojtabai, R, Cohen, LJ, Galynker, II (2011). Panic as an independent risk factor for suicide attempt in depressive illness: findings from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Journal of Clinical Psychiatry 72, 16281635.
Kendler, KS, Karkowski, LM, Prescott, CA (1998). Stressful life events and major depression: risk period, long-term contextual threat, and diagnostic specificity. Journal of Nervous and Mental Diseases 186, 661669.
Kendler, KS, Prescott, CA (2006). Genes, Environment, and Psychopathology. Guildford Press: New York.
Linehan, MM (1986). Suicidal people. One population or two? Annals of the New York Academy of Sciences 487, 1633.
Malone, KM, Haas, GL, Sweeney, JA, Mann, JJ (1995). Major depression and the risk of attempted suicide. Journal of Affective Disorders 34, 173185.
Mann, JJ (2002). A current perspective of suicide and attempted suicide. Annals of Internal Medicine 136, 302311.
Martin, J, Anderson, J, Romans, S, Mullen, P, O'Shea, M (1993). Asking about child sexual abuse: methodological implications of a two stage survey. Child Abuse and Neglect 17, 383392.
McGirr, A, Renaud, J, Seguin, M, Alda, M, Benkelfat, C, Lesage, A, Turecki, G (2007). An examination of DSM-IV depressive symptoms and risk for suicide completion in major depressive disorder: a psychological autopsy study. Journal of Affective Disorders 97, 203209.
Nakagawa, A, Grunebaum, MF, Oquendo, MA, Burke, AK, Kashima, H, Mann, JJ (2009). Clinical correlates of planned, more lethal suicide attempts in major depressive disorder. Journal of Affective Disorders 112, 237242.
Oquendo, MA, Galfalvy, H, Russo, S, Ellis, SP, Grunebaum, MF, Burke, A, Mann, JJ (2004). Prospective study of clinical predictors of suicidal acts after a major depressive episode in patients with major depressive disorder or bipolar disorder. American Journal of Psychiatry 161, 14331441.
Osby, U, Brandt, L, Correia, N, Ekbom, A, Sparen, P (2001). Excess mortality in bipolar and unipolar disorder in Sweden. Archives of General Psychiatry 58, 844850.
Placidi, GP, Oquendo, MA, Malone, KM, Brodsky, B, Ellis, SP, Mann, JJ (2000). Anxiety in major depression: relationship to suicide attempts. American Journal of Psychiatry 157, 16141618.
Roy, A (1993). Features associated with suicide attempts in depression: a partial replication. Journal of Affective Disorders 27, 3538.
Roy, A (2004). Relationship of childhood trauma to age of first suicide attempt and number of attempts in substance dependent patients. Acta Psychiatrica Scandinavica 109, 121125.
Sareen, J, Cox, BJ, Afifi, TO, de Graaf, R, Asmundson, GJ, ten Have, M, Stein, MB (2005). Anxiety disorders and risk for suicidal ideation and suicide attempts: a population-based longitudinal study of adults. Archives of General Psychiatry 62, 12491257.
Seo, HJ, Jung, YE, Kim, TS, Kim, JB, Lee, MS, Kim, JM, Lim, HW, Jun, TY (2011). Distinctive clinical characteristics and suicidal tendencies of patients with anxious depression. Journal of Nervous and Mental Disease 199, 4248.
Sokero, TP, Melartin, TK, Rytsala, HJ, Leskela, US, Lestela-Mielonen, PS, Isometsa, ET (2003). Suicidal ideation and attempts among psychiatric patients with major depressive disorder. Journal of Clinical Psychiatry 64, 10941100.
Sokero, TP, Melartin, TK, Rytsala, HJ, Leskela, US, Lestela-Mielonen, PS, Isometsa, ET (2005). Prospective study of risk factors for attempted suicide among patients with DSM-IV major depressive disorder. British Journal of Psychiatry 186, 314318.
Soloff, PH, Lynch, KG, Kelly, TM, Malone, KM, Mann, JJ (2000). Characteristics of suicide attempts of patients with major depressive episode and borderline personality disorder: a comparative study. American Journal of Psychiatry 157, 601608.
Statham, DJ, Heath, AC, Madden, PA, Bucholz, KK, Bierut, L, Dinwiddie, SH, Slutske, WS, Dunne, MP, Martin, NG (1998). Suicidal behaviour: an epidemiological and genetic study. Psychological Medicine 28, 839855.
Stein, MB, Fuetsch, M, Muller, N, Hofler, M, Lieb, R, Wittchen, HU (2001). Social anxiety disorder and the risk of depression: a prospective community study of adolescents and young adults. Archives of General Psychiatry 58, 251256.
WHO (1997). Composite International Diagnostic Interview (CIDI), Version 2.1. World Health Organization: Geneva.

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