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. 2011:2011:896395.
doi: 10.1155/2011/896395. Epub 2011 May 12.

Antidepressant therapy in severe depression may have different effects on ego-dystonic and ego-syntonic suicidal ideation

Affiliations

Antidepressant therapy in severe depression may have different effects on ego-dystonic and ego-syntonic suicidal ideation

Louise Brådvik et al. Depress Res Treat. 2011.

Abstract

The objective of the present study was to investigate whether ego-dystonic and ego-syntonic suicidal ideation occurred at different frequencies during antidepressant therapy. A blind evaluation has been performed on records of 100 suicides with a primary severe depression and 100 matched controls, admitted to the Department of Psychiatry, Lund, Sweden. Ego-dystonic suicidal ideation was more commonly reported during adequate treatment as compared to ego-syntonic ideation (P = .004). Men who committed suicide during adequate antidepressant therapy more often reported ego-dystonic suicidal ideation earlier in their lives compared with those who were not treated (P = .0377). This may indicate that treatment failure for ego-dystonic ideation was a precursor of their suicides. Consequently, ego-dystonic ideation seems to show a poorer response to antidepressant therapy as compared to ego-syntonic ideation, which may be more directly related to depression. Ego-dystonic ideation is proposed to be related to depressive psychosis.

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Figures

Figure 1
Figure 1
Flow-diagram for the sample of patients with severe depression admitted to the Department of Psychiatry, Lund University Hospital.
Figure 2
Figure 2
The proportion of reported ego-dystonic and ego-syntonic suicidal ideation during adequate treatment related to the total number of reported ego-dystonic and ego-syntonic ideation (percent).
Figure 3
Figure 3
The proportion of individuals who reported ego-dystonic and ego-syntonic suicidal ideation during adequate treatment only, related to the total number of individuals who had at some time reported ego-dystonic and ego-syntonic ideation (percent).

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