Anne Katrine K Leadholm1, Anthony J Rothschild2, Jimmi Nielsen3, Per Bech4, Søren D Ostergaard5. 1. Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg University Hospital, Aalborg, Denmark; Psychiatric research Unit, Psychiatric Center North Zealand, University of Copenhagen, Hillerød, Denmark. Electronic address: a.k.leadholm@gmail.com. 2. University of Massachusetts Medical School and UMass Memorial Health Care, Worcester, MA, USA. 3. Center for Schizophrenia, Aalborg Psychiatric Hospital, Aalborg University Hospital, Aalborg, Denmark. 4. Psychiatric research Unit, Psychiatric Center North Zealand, University of Copenhagen, Hillerød, Denmark. 5. Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg University Hospital, Aalborg, Denmark; Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark; Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Abstract
BACKGROUND: Severe unipolar depression is associated with increased risk of suicide, but it remains unknown whether the same risk factors are present in the non-psychotic (non-PD) and psychotic (PD) subtypes respectively. Therefore, this study aimed to identify risk factors for suicide in non-PD and PD separately, and to investigate if the presence of psychotic symptoms is an independent risk factor for suicide in severe depression. METHODS: This register-based, nationwide, historical prospective cohort study used logistic regression analyses to ascertain risk factors for suicide among all adults diagnosed with severe depression at Danish psychiatric hospitals between January 1, 1994 and December 31, 2010. The risk for suicide was expressed as adjusted odds ratios (AOR). RESULTS: A total of 34,671 individuals with severe depression (non-PD: n=26,106 and PD: n=12,101) were included in the study. Of these, 755 completed suicide during follow up. PD was not found to be an independent risk factor for suicide in severe depression (AOR=0.97 [0.83-1.15]). Older age (non-PD AOR=1.05 [per year], PD AOR=1.04 [per year]), male sex (non-PD AOR=1.89, PD AOR=1.98), and a previous incident of self-harm (non-PD AOR=5.02, PD AOR=5.17) were significant risk factors for both groups. LIMITATIONS: As the study population was comprised only of patients with contact to psychiatric hospitals, the results cannot be extrapolated to the primary care setting. CONCLUSION: The following risk factors for non-PD and PD were identified: older age, male gender and previous incidents of self-harm. In suicide prevention efforts, equal attention should be paid to non-PD and PD patients.
BACKGROUND: Severe unipolar depression is associated with increased risk of suicide, but it remains unknown whether the same risk factors are present in the non-psychotic (non-PD) and psychotic (PD) subtypes respectively. Therefore, this study aimed to identify risk factors for suicide in non-PD and PD separately, and to investigate if the presence of psychotic symptoms is an independent risk factor for suicide in severe depression. METHODS: This register-based, nationwide, historical prospective cohort study used logistic regression analyses to ascertain risk factors for suicide among all adults diagnosed with severe depression at Danish psychiatric hospitals between January 1, 1994 and December 31, 2010. The risk for suicide was expressed as adjusted odds ratios (AOR). RESULTS: A total of 34,671 individuals with severe depression (non-PD: n=26,106 and PD: n=12,101) were included in the study. Of these, 755 completed suicide during follow up. PD was not found to be an independent risk factor for suicide in severe depression (AOR=0.97 [0.83-1.15]). Older age (non-PD AOR=1.05 [per year], PD AOR=1.04 [per year]), male sex (non-PD AOR=1.89, PD AOR=1.98), and a previous incident of self-harm (non-PD AOR=5.02, PD AOR=5.17) were significant risk factors for both groups. LIMITATIONS: As the study population was comprised only of patients with contact to psychiatric hospitals, the results cannot be extrapolated to the primary care setting. CONCLUSION: The following risk factors for non-PD and PD were identified: older age, male gender and previous incidents of self-harm. In suicide prevention efforts, equal attention should be paid to non-PD and PDpatients.
Authors: Kate H Bentley; Joseph C Franklin; Jessica D Ribeiro; Evan M Kleiman; Kathryn R Fox; Matthew K Nock Journal: Clin Psychol Rev Date: 2015-12-02
Authors: Ayal Schaffer; Erkki T Isometsä; Leonardo Tondo; Doris H Moreno; Gustavo Turecki; Catherine Reis; Frederick Cassidy; Mark Sinyor; Jean-Michel Azorin; Lars Vedel Kessing; Kyooseob Ha; Tina Goldstein; Abraham Weizman; Annette Beautrais; Yuan-Hwa Chou; Nancy Diazgranados; Anthony J Levitt; Carlos A Zarate; Zoltán Rihmer; Lakshmi N Yatham Journal: Bipolar Disord Date: 2014-10-20 Impact factor: 6.744
Authors: Kristin J Fredriksen; Margrethe A Schaufel; Jan O Johannessen; Fredrik A Walby; Larry Davidson; Helle K Schoeyen Journal: Psychiatr Q Date: 2020-03
Authors: Søren D Østergaard; Anthony J Rothschild; Alastair J Flint; Benoit H Mulsant; Ellen M Whyte; Tom Vermeulen; Per Bech; Barnett S Meyers Journal: J Affect Disord Date: 2015-10-22 Impact factor: 4.839
Authors: R C Kessler; M B Stein; M V Petukhova; P Bliese; R M Bossarte; E J Bromet; C S Fullerton; S E Gilman; C Ivany; L Lewandowski-Romps; A Millikan Bell; J A Naifeh; M K Nock; B Y Reis; A J Rosellini; N A Sampson; A M Zaslavsky; R J Ursano Journal: Mol Psychiatry Date: 2016-07-19 Impact factor: 15.992