High levels of hopelessness persist in geriatric patients with remitted depression and a history of attempted suicide.
OBJECTIVE
To determine whether a high level of hopelessness after treatment of a depressive episode is an indicator of a history of lifetime suicide attempts in older people.


METHODS
Groups of suicide attempters, suicidal ideators, and nonsuicidal patients were compared via analysis of variance with respect to levels of hopelessness, depression, anxiety, and global functioning before and after treatment of depression.


METHODS
An outpatient research clinic providing two treatment protocols of late-life mood disorders.


METHODS
A total of 107 consecutive outpatients (mean age 67) with major depression who responded to treatment.


METHODS
Levels of hopelessness, severity of depression, anxiety, and global functioning were compared across the three groups at the beginning of treatment and at remission.


RESULTS
After remission there were no differences between the three groups in depression severity, anxiety, and global functioning. Hopelessness remained significantly higher in the attempter group than among ideators or nonsuicidal patients.


CONCLUSIONS
Suicide attempts, the most important risk factor for subsequent suicide, are associated with persistent, high levels of hopelessness following remission of depression in late-life patients. These findings suggest that treatments designed specifically to lower hopelessness (such as cognitive, behavioral or interpersonal therapy) may be effective in reducing suicide risk.
Szanto
K
K
Mental Health Clinical Research Center for the Study of Late-Life Mood Disorders, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
Reynolds
C F
CF
Conwell
Y
Y
Begley
A E
AE
Houck
P
P
D000368:Aged / Q000523:psychology*; D000704:Analysis of Variance; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009013:Morale; D010552:Personality Assessment; D012008:Recurrence; D012074:Remission Induction; D012720:Severity of Illness Index; D013406:Suicide, Attempted / Q000523:psychology*; D016896:Treatment Outcome