Relationship Between a History of a Suicide Attempt and Treatment Outcomes in Patients With Depression
- Author(s)
- Sung-Wan Kim; Robert Stewart; Jae-Min Kim; Il-Seon Shin; Jin-Sang Yoon; Sung-Won Jung; Min-Soo Lee; Hyeon-Woo Yim; Tae-Youn Jun
- Keimyung Author(s)
- Jung, Sung Won
- Department
- Dept. of Psychiatry (정신건강의학)
- Journal Title
- Journal of Clinical Psychopharmacology
- Issued Date
- 2011
- Volume
- 31
- Issue
- 4
- Abstract
- This study aimed to investigate the sociodemographic and
clinical correlates of a history of a suicide attempt in people with depression
and their relationship with treatment outcomes and subsequent
suicidal ideation and deliberate self-harm. Patients with depressive disorders
according to the Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition, were recruited from 18 hospitals across
South Korea. Data on sociodemographic and clinical characteristics
were obtained, and scales assessing depression, anxiety, and general
functioning were administered during the first 12 weeks of antidepressant
treatment. Baseline characteristics, responses to treatment, and
suicidal ideation/deliberate self-harm during the follow-up period were
compared according to a reported history or not of a suicide attempt. In
a total of 723 participants, 143 (19.8%) with a history of a suicide attempt
had an earlier age of onset, longer duration of illness, and a greater number
of depressive episodes. Levels of depression and anxiety were significantly
higher at baseline in this group who also experienced significantly
lower remission and response rates, as well as longer time to remission.
The case group was more likely to experience new suicidal ideation and
carry out a deliberate self-harm act during the 12-week treatment period.
In conclusion, a history of a suicide attempt in a Korean population with
depression was characterized by more severe psychopathology, poorer
treatment outcomes, and higher subsequent suicidal ideation and self-harm.
Therefore, more intensive and longer-term treatment with particular ongoing
clinical attention to risk is indicated in patients with these distinct,
chronic, and severe forms of depression and ongoing high suicide risk.
Key Words: suicide, suicide attempts, depression, remission,
CRESCEND
(J Clin Psychopharmacol 2011;31: 449Y456)
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