Indicators of Suicide Over 10 Years in a Specialist Mood Disorders Unit Sample
J Clin Psychiatry 2001;62(12):945-951
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: There are few firm data to guide the clinician in
identifying individual depressed patients who may be at high risk for completing
suicide. In particular, there have been few prospective studies of well-characterized
depressed patients to determine indicators of such future events.
Method: Eight hundred thirteen patients with a major depressive
episode (DSM-III, DSM-III-R, or DSM-IV criteria) were assessed in detail in
a specialist Mood Disorders Unit (MDU) over a 10-year period. Follow-up at the
end of that period (mean = 5.1 years) confirmed that 31 patients (3.8%) had
completed suicide. The suicide completers were compared on a broad range of
clinical and demographic variables obtained at baseline with (1) the total remaining
depressed sample, (2) 31 age- and sex-matched subjects who were confirmed to
be alive and had never attempted suicide, and (3) 24 age- and sex-matched living
subjects who had made at least 1 suicide attempt.
Results: The most consistent finding, across all 3 comparisons,
was that the suicide completers were more likely to have been inpatients at
the time of the index MDU assessment. Other characteristics of completers were
a greater number of prior admissions for depression, being older and in a relationship,
and being male and married or female and single. Somewhat paradoxically, suicide
completers also evidenced fewer previous suicide attempts and less suicidal
ideation compared with living subjects who had attempted suicide at the time
of index assessment.
Conclusion: Overall, we were able to find few predictors of later
suicide in this sample. Those who completed suicide demonstrated evidence of
more severe illness over a lifetime (for example, having more admissions), but
revealed less suicidal ideation at the time of the index MDU assessment. While
these features were statistically significant, they are of limited usefulness
in predicting suicide in an individual patient.