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Multicenter Study
. 2018 Jun 1;21(6):539-549.
doi: 10.1093/ijnp/pyy009.

Major Depression and the Degree of Suicidality: Results of the European Group for the Study of Resistant Depression (GSRD)

Markus Dold  1 , Lucie Bartova  1 , Gernot Fugger  1 , Alexander Kautzky  1 , Daniel Souery  2   3 , Julien Mendlewicz  2 , George N Papadimitriou  4 , Dimitris Dikeos  4 , Panagiotis Ferentinos  5 , Stefano Porcelli  6 , Alessandro Serretti  6 , Joseph Zohar  7 , Stuart Montgomery  8 , Siegfried Kasper  1
Affiliations
Multicenter Study

Major Depression and the Degree of Suicidality: Results of the European Group for the Study of Resistant Depression (GSRD)

Markus Dold et al. Int J Neuropsychopharmacol. .

Abstract

Background: This European multicenter study aimed to elucidate suicidality in major depressive disorder. Previous surveys suggest a prevalence of suicidality in major depressive disorder of ≥50%, but little is known about the association of different degrees of suicidality with socio-demographic, psychosocial, and clinical characteristics.

Methods: We stratified 1410 major depressive disorder patients into 3 categories of suicidality based on the Hamilton Rating Scale for Depression item 3 (suicidality) ratings (0=no suicidality; 1-2=mild/moderate suicidality; 3-4=severe suicidality). Chi-squared tests, analyses of covariance, and Spearman correlation analyses were applied for the data analyses.

Results: The prevalence rate of suicidality in major depressive disorder amounted to 46.67% (Hamilton Rating Scale for Depression item 3 score ≥1). 53.33% were allocated into the no, 38.44% into the mild/moderate, and 8.23% into the severe suicidality patient group. Due to the stratification of our major depressive disorder patient sample according to different levels of suicidality, we identified some socio-demographic, psychosocial, and clinical variables differentiating from the patient group without suicidality already in presence of mild/moderate suicidality (depressive symptom severity, treatment resistance, psychotic features, add-on medications in general), whereas others separated only when severe suicidality was manifest (inpatient treatment, augmentation with antipsychotics and benzodiazepines, melancholic features, somatic comorbidities).

Conclusions: As even mild/moderate suicidality is associated with a failure of achieving treatment response, adequate recognition of this condition should be ensured in the clinical practice.

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Figures

Figure 1.
Figure 1.
Hamilton Rating Scale for Depression (HAM-D) item 3 (suicidality) ratings.
Figure 2.
Figure 2.
Treatment response, nonresponse, and resistance rates in the no, mild/moderate, and severe suicidality patient groups.
See this image and copyright information in PMC

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