Sergio Castro-Díaz1, Carlos Gómez-Restrepo2, Fabián Gil3, Miguel Uribe Restrepo4, Carlos Miranda5, Mauricio de la Espriella6, Álvaro Arenas7, Diana Pinto8. 1. Médico, residente de Psiquiatría de tercer año, Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Bogotá, Colombia. Electronic address: sergiomariocastro@gmail.com. 2. Médico psiquiatra, psicoanalista, epidemiólogo clínico, profesor del Departamento de Psiquiatría y Salud Mental, director del Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia. 3. Estadístico y bioestadístico, profesor asistente del Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia. 4. Médico psiquiatra, psicoanalista, Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Bogotá, Colombia. 5. Médico psiquiatra, director médico del Hospital Psiquiátrico Universitario del Valle, profesor de la Universidad del Valle, Cali, Colombia. 6. Médico psiquiatra, director médico de la Clínica Nuestra Señora del Perpetuo Socorro, Pasto. Profesor del Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Pasto, Colombia. 7. Médico psiquiatra, director científico de la Clínica la Inmaculada. Instructor del Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Bogotá, Colombia. 8. Médica, magistra en Administración de Salud, DSc en Economía y Política de Salud Internacional. Profesora asociada del Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia.
Abstract
INTRODUCTION: Suicidal ideation is a poor prognostic factor in patients with depression, due to the risk of suicide attempt or completed suicide. However, it is a relatively unexplored aspect in the Colombian population. It is important to identify the associated factors in order to develop appropriate treatment strategies. OBJECTIVE: To identify risk factors for suicidal ideation in patients with major depressive disorder between 18 and 65 years in 5 Colombian cities. METHODS: Data from 295 patients diagnosed with major depressive disorder were used from the Study of the Economic Burden of Depression in Colombia. The association between the clinical and psychosocial variables with the presence of suicidal ideation was assessed using two-level hierarchical models. RESULTS: Female sex was a factor associated with a lower risk of suicidal ideation. Factors associated with the presence of suicidal ideation include unemployment, smoking and alcohol use in the past 30 days, mental health perceived as fair or poor, diagnosis of double depression, inpatient treatment, low income, unemployment, and a major financial crisis in the last 2 years. CONCLUSIONS: Suicidal ideation is highly prevalent in patients with major depressive disorder. Risk factors associated with both the clinical and psychosocial domain must be carefully evaluated during risk assessment of patients with this diagnosis.
INTRODUCTION: Suicidal ideation is a poor prognostic factor in patients with depression, due to the risk of suicide attempt or completed suicide. However, it is a relatively unexplored aspect in the Colombian population. It is important to identify the associated factors in order to develop appropriate treatment strategies. OBJECTIVE: To identify risk factors for suicidal ideation in patients with major depressive disorder between 18 and 65 years in 5 Colombian cities. METHODS: Data from 295 patients diagnosed with major depressive disorder were used from the Study of the Economic Burden of Depression in Colombia. The association between the clinical and psychosocial variables with the presence of suicidal ideation was assessed using two-level hierarchical models. RESULTS: Female sex was a factor associated with a lower risk of suicidal ideation. Factors associated with the presence of suicidal ideation include unemployment, smoking and alcohol use in the past 30 days, mental health perceived as fair or poor, diagnosis of double depression, inpatient treatment, low income, unemployment, and a major financial crisis in the last 2 years. CONCLUSIONS: Suicidal ideation is highly prevalent in patients with major depressive disorder. Risk factors associated with both the clinical and psychosocial domain must be carefully evaluated during risk assessment of patients with this diagnosis.