TY - JOUR
T1 - Clinical and sociodemographic characteristics associated with suicidal ideation in depressed outpatients
AU - Trivedi, Madhukar H.
AU - Morris, David W.
AU - Wisniewski, Stephen R.
AU - Nierenberg, Andrew A.
AU - Gaynes, Bradley N.
AU - Kurian, Benji T.
AU - Warden, Diane
AU - Stegman, Diane
AU - Shores-Wilson, Kathy
AU - Rush, A. John
PY - 2013/2
Y1 - 2013/2
N2 - Objective: To identify clinical and sociodemographic characteristics associated with suicidal ideation (SI) among patients seeking care for depression in routine primary and psychiatric care settings. Methods: We examined data from 4041 treatment-seeking outpatients with major depressive disorder (MDD) to compare baseline sociodemographic and clinical characteristics of those with and without SI, and the presence or absence of baseline depressive symptoms and psychiatric comorbidities in those with SI. Results: SI was significantly (P < 0.01) associated with numerous sociodemographic characteristics (that is, lower level of education, Caucasian or African American, male, unemployed, and treated in psychiatric care) and clinical features (that is, previous suicide attempt, younger age of MDD onset, greater baseline depressive symptom severity, greater number of depressive symptoms, and presence of agoraphobia and [or] generalized anxiety disorder). Elevated levels of SI at baseline were associated with decreased remission rates. Conclusions: Consistent with past findings, increased rates of SI were associated with greater depressive symptom severity as well as other features suggestive of severity of illness. Our results confirm previous findings of associations between SI and panic and (or) phobic symptoms and anxiety, but did not confirm previous findings of an association between SI and alcohol or drug use and (or) dependence. While selective serotonin reuptake inhibitor monotherapy appeared significantly helpful in reducing SI during the course of treatment, the presence of SI at baseline was found to be a associated with decreased treatment response, with patients reporting SI at the start of treatment being less likely to achieve remission. Clinical Trial Registration Number: Sequenced Treatment Alternatives to Relieve Depression, NCT00021528.
AB - Objective: To identify clinical and sociodemographic characteristics associated with suicidal ideation (SI) among patients seeking care for depression in routine primary and psychiatric care settings. Methods: We examined data from 4041 treatment-seeking outpatients with major depressive disorder (MDD) to compare baseline sociodemographic and clinical characteristics of those with and without SI, and the presence or absence of baseline depressive symptoms and psychiatric comorbidities in those with SI. Results: SI was significantly (P < 0.01) associated with numerous sociodemographic characteristics (that is, lower level of education, Caucasian or African American, male, unemployed, and treated in psychiatric care) and clinical features (that is, previous suicide attempt, younger age of MDD onset, greater baseline depressive symptom severity, greater number of depressive symptoms, and presence of agoraphobia and [or] generalized anxiety disorder). Elevated levels of SI at baseline were associated with decreased remission rates. Conclusions: Consistent with past findings, increased rates of SI were associated with greater depressive symptom severity as well as other features suggestive of severity of illness. Our results confirm previous findings of associations between SI and panic and (or) phobic symptoms and anxiety, but did not confirm previous findings of an association between SI and alcohol or drug use and (or) dependence. While selective serotonin reuptake inhibitor monotherapy appeared significantly helpful in reducing SI during the course of treatment, the presence of SI at baseline was found to be a associated with decreased treatment response, with patients reporting SI at the start of treatment being less likely to achieve remission. Clinical Trial Registration Number: Sequenced Treatment Alternatives to Relieve Depression, NCT00021528.
KW - Anxiety
KW - Depression
KW - Major depressive disorder
KW - Suicidal ideation
KW - Suicide assessment
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U2 - 10.1177/070674371305800209
DO - 10.1177/070674371305800209
M3 - Article
C2 - 23442899
AN - SCOPUS:84874298749
SN - 0706-7437
VL - 58
SP - 113
EP - 122
JO - Canadian Journal of Psychiatry
JF - Canadian Journal of Psychiatry
IS - 2
ER -