Déborah Ducasse1,2,3, Jonathan Dubois2, Isabelle Jaussent2, Jean-Michel Azorin3,4, Bruno Etain3,5, Sébastien Gard3,6, Chantal Henry3,5, Thierry Bougerol3,7, Jean-Pierre Kahn3,8, Valérie Aubin3,9, Frank Bellivier3,10, Raoul Belzeaux3,4, Caroline Dubertret3,11,12, Julien Dubreucq3,7, Pierre-Michel Llorca13, Josephine Loftus3,9, Christine Passerieux3,14, Mircea Polosan3,7, Ludovic Samalin13, Marion Leboyer3,5, Antoine Yrondi3,15, Djamila Bennabi3,16, Emmanuel Haffen3,17, Julia Maruani3,18, Etienne Allauze3,13, Vincent Camus19, Thierry D'Amato20, Olivier Doumy6, Jérôme Holtzmann7, Christophe Lançon21, Fanny Moliere1, Rémi Moirand20, Raphaëlle Marie Richieri21, Mathilde Horn22, Laurent Schmitt15, Florian Stephan23, Jean-Baptiste Genty13, Guillaume Vaiva22, Michel Walter23, Wissam El-Hage19, Bruno Aouizerate6, Emilie Olié1,2,3, Philippe Courtet1,2,3. 1. CHU Montpellier, Hôpital Lapeyronie, Department of Emergency Psychiatry and Post Acute Care, CHRU, Montpellier, France. 2. Inserm, U1061 Montpellier, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France. 3. Fondation FondaMental, Créteil, France. 4. AP HM, Psychiatric Pole, Marseille, France. 5. Université Paris-Est, Hopital Henri Mondor, DHU PePSY and AP-HP, Créteil, France. 6. Charles Perrens Hospital, Bordeaux, France. 7. Service de Psychiatrie de l'adulte, CS 10217, Centre Expert Dépression Résistante FondaMental, CHU de Grenoble, Hôpital Nord, Grenoble, France. 8. Brabois Hospital, Academic Hospital of Nancy, Vandoeuvre Les Nancy, France. 9. Department of Psychiatry, Princesse-Grace Hospital, La Colle, Monaco. 10. Hospital Saint-Louis-Lariboisière-Fernand Widal, AP-HP, Paris, France. 11. Department of Psychiatry, Louis Mourier Hospital, AP-HP, INSERM U894, School of Medicine, Paris Diderot University, Sorbonne Paris Cité, France. 12. Department of Psychiatry and Clinical Psychology, Psychotherapy Center of Nancy and School of Medicine, Lorraine University, Lorraine, France. 13. Service de Psychiatrie de l'adulte B, Centre Expert Dépression Résistante FondaMental, CHU de Clermont-Ferrand, Clermont-Ferrand, France. 14. Academic Hospital of Versailles, Le Chesnay, France. 15. Service de Psychiatrie et de Psychologie Médicale de l'adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Toulouse, Hôpital Purpan, Toulouse, France. 16. Service de Psychiatrie clinique, Centre Expert Dépression Résistante FondaMental, EA 481 Neurosciences, Université de Bourgogne Franche Comté, Besançon, France. 17. Service de Psychiatrie clinique, Centre Expert Dépression Résistante FondaMental, Centre Investigation Clinique 1431-INSERM, EA 481 Neurosciences, Université de Bourgogne Franche Comté, Besançon, France. 18. Service de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, Hôpital Fernand-Widal, Paris, France. 19. Clinique Psychiatrique Universitaire, Centre Expert Dépression Résistante FondaMental, Inserm U1253 Imaging and Brain, CHRU de Tours, Tours, France. 20. Service Universitaire de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, Centre Hospitalier Le Vinatier, Bron cedex, France. 21. Pôle Psychiatrie, Centre Expert Dépression Résistante FondaMental, CHU La Conception, Marseille, France. 22. Service de Psychiatrie adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Lille, Hôpital Fontan 1, Lille, France. 23. Service de Psychiatrie de l'adulte, Centre Expert Dépression Résistante FondaMental, CHU de Brest, Hôpital de Bohars, Bohars, France.
Abstract
BACKGROUND: As almost all mental disorders are associated with increased suicidal-related behavior, anhedonia might be a trans-diagnostic dimension to target for suicide prevention. METHODS: For this 3-year-long prospective study, 2,839 outpatients with mood disorders were recruited. They were divided in: (a) two groups according to the occurrence or not of suicidal ideation during the follow-up, and (b) two groups according to the occurrence or not of suicide attempts during the follow-up. Anhedonia was assessed using a composite score (the French version of the 14-item Snaith-Hamilton Pleasure Scale and item 13 of the Quick Inventory of Depressive Symptomatology scale) at inclusion and at 6, 12, 24, and 36 months after inclusion. RESULTS: Patients with mood disorders and anhedonia at least at one follow-up visit had a 1.4-fold higher risk of suicidal ideation (adjusted odds ratio = 1.35; 95% confidence interval [1.07, 1.70]), even after adjustment for confounding factors of suicide risk (i.e., bipolar or unipolar disorder, sex, age, marital status, education level, antidepressant intake, personal history of suicide attempt, at least one childhood trauma, and mean of the maximum depression score during the follow-up). Conversely, association between anhedonia and suicide attempt did not remain significant after adjustment. CONCLUSIONS: The significant association between anhedonia and suicide ideation in patients with mood disorders stresses the need of targeting hedonia in mood disorders, and of research focusing on the position to pleasure in life through eudaimonia.
BACKGROUND: As almost all mental disorders are associated with increased suicidal-related behavior, anhedonia might be a trans-diagnostic dimension to target for suicide prevention. METHODS: For this 3-year-long prospective study, 2,839 outpatients with mood disorders were recruited. They were divided in: (a) two groups according to the occurrence or not of suicidal ideation during the follow-up, and (b) two groups according to the occurrence or not of suicide attempts during the follow-up. Anhedonia was assessed using a composite score (the French version of the 14-item Snaith-Hamilton Pleasure Scale and item 13 of the Quick Inventory of Depressive Symptomatology scale) at inclusion and at 6, 12, 24, and 36 months after inclusion. RESULTS: Patients with mood disorders and anhedonia at least at one follow-up visit had a 1.4-fold higher risk of suicidal ideation (adjusted odds ratio = 1.35; 95% confidence interval [1.07, 1.70]), even after adjustment for confounding factors of suicide risk (i.e., bipolar or unipolar disorder, sex, age, marital status, education level, antidepressant intake, personal history of suicide attempt, at least one childhood trauma, and mean of the maximum depression score during the follow-up). Conversely, association between anhedonia and suicide attempt did not remain significant after adjustment. CONCLUSIONS: The significant association between anhedonia and suicide ideation in patients with mood disorders stresses the need of targeting hedonia in mood disorders, and of research focusing on the position to pleasure in life through eudaimonia.