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Feelings of worthlessness during a single complicated major depressive episode predict postremission suicide attempt
Author(s) -
Wakefield J. C.,
Schmitz M. F.
Publication year - 2016
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12521
Subject(s) - suicidal ideation , feeling , suicide prevention , poison control , suicide attempt , major depressive episode , psychiatry , injury prevention , psychomotor retardation , occupational safety and health , medicine , psychology , clinical psychology , medical emergency , mood , social psychology , alternative medicine , pathology
Objective To establish which symptoms of major depressive episode ( MDE ) predict postremission suicide attempts in complicated single‐episode cases. Method Using the nationally representative two‐wave National Epidemiologic Survey on Alcohol and Related Conditions data set, we identified wave 1 lifetime single‐episode MDE cases in which the episode remitted by the beginning of the wave 2 three‐year follow‐up period ( N = 2791). The analytic sample was further limited to ‘complicated’ cases ( N = 1872) known to have elevated suicide attempt rates, defined as having two or more of the following: suicidal ideation, marked role impairment, feeling worthless, psychomotor retardation, and prolonged (>6 months) duration. Results Logistic regression analyses showed that, after controlling for wave 1 suicide attempt which significantly predicted postremission suicide attempt ( OR = 10.0), the additional complicated symptom ‘feelings of worthlessness’ during the wave 1 index episode significantly and very substantially predicted postremission suicide attempt ( OR = 6.96). Neither wave 1 psychomotor retardation nor wave 1 suicidal ideation nor any of the other wave 1 depressive symptoms were significant predictors of wave 2 suicide attempt. Conclusion Among depressive symptoms during an MDE , feelings of worthlessness is the only significant indicator of elevated risk of suicide attempt after the episode has remitted, beyond previous suicide attempts.