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Suicidal status during antidepressant treatment in 789 Sardinian patients with major affective disorder
Author(s) -
Tondo L.,
Lepri B.,
Baldessarini R. J.
Publication year - 2008
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/j.1600-0447.2008.01178.x
Subject(s) - suicidal ideation , major depressive disorder , antidepressant , depression (economics) , psychiatry , rating scale , poison control , psychology , hamilton rating scale for depression , medicine , suicide prevention , clinical psychology , mood , anxiety , medical emergency , developmental psychology , economics , macroeconomics
Objective: Relationships between antidepressant treatment and suicidality remain uncertain in major depressive disorder (MDD), and rarely evaluated in bipolar disorder (BPD). Method: We evaluated changes in suicidality ratings (Hamilton Depression Rating Scale item‐3) at the start and after 3.59 ± 2.57 months of sustained antidepressant treatment in a systematically assessed clinical sample ( n = 789) of 605 patients with MDD, 103 patients with BPD‐II and 81 patients with BPD‐I (based on DSM‐IV; 68.1% women; aged 44.3 ± 16.1 years), comparing suicidal vs. non‐suicidal and recovered vs. unrecovered initially suicidal patients. Results: Suicidal patients (103/789, 16.5%; BPD/MDD risk: 2.2) were more depressed and were ill longer. During treatment, 81.5% of suicidal patients became non‐suicidal; 0.46% of 656 initially non‐suicidal patients reported new suicidal thoughts, with no new attempts. Becoming non‐suicidal was associated with greater depression severity and greater improvement. Conclusion: Suicidal ideation was prevalent in patients with depressed major affective disorder, but most of the initially suicidal patients became non‐suicidal with antidepressant treatment, independent of diagnosis, treatment type or dose.