Seon-Cheol Park1, Min-Soo Lee2, Sang Woo Hahn3, Tian-Mei Si4, Shigenobu Kanba5, Mian-Yoon Chong6, Chee Kok Yoon7, Pichet Udomratn8, Adarsh Tripathi9, Norman Sartorius10, Naotaka Shinfuku11, Margarita M Maramis12, Yong Chon Park13. 1. 1Department of Psychiatry,Inje University Haeundae Paik Hospital,Busan,Korea. 2. 2Department of Psychiatry,Korea University College of Medicine,Seoul,Korea. 3. 3Department of Psychiatry,Soonchunhyang University Seoul Hospital,Seoul,Korea. 4. 4Peking University Institute of Mental Health,Beijing,China. 5. 5Department of Neuropsychiatry,Graduate School of Medical Sciences,Kyushu University,Fukuoka,Japan. 6. 6School of Medicine,Kaohsiung Chang Gung Memorial Hospital,Chang Gung University,Kaohsiung,Taiwan. 7. 7Department of Psychiatry and Mental Health,Tunku Abdul Rahman Institute of Neuroscience,Kuala Lumpur Hospital,Kuala Lumpur,Malaysia. 8. 8Department of Psychiatry, Faculty of Medicine,Prince of Songkla University,Songkhla,Thailand. 9. 9King George's Medical University,Chowk,Lucknow,India. 10. 10Association for the Improvement of Mental Health Programs,Geneva,Switzerland. 11. 11Department of Social Welfare,School of Human Sciences,Seinan Gakuin University,Fukuoka,Japan. 12. 12Department of Psychiatry, Faculty of Medicine,University of Airlangga/Dr. Soetomo General Hospital,Surabaya,Indonesia. 13. 13Department of Psychiatry,Hanyang University Guri Hospital,Guri,Korea.
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.
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 depressedpatients 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.