title: Inadequacy of antidepressant treatment for patients with major depression who are at risk for suicidal behavior.
abstract: OBJECTIVE
  The authors' goal was to determine whether suicide attempters with major depression received more intensive antidepressant treatment than depressed patients who had not attempted suicide.
  
  
  METHODS
  One hundred eighty inpatients who met DSM-III-R criteria for a major depressive episode according to the Structured Clinical Interview for DSM-III-R were enrolled in the study. All patients were assessed for lifetime history of suicide attempts. Depressive symptoms at the index hospitalization were assessed with the Hamilton Depression Rating Scale and the Beck Depression Inventory. Strength of antidepressant treatment over the 90 days preceding the hospitalization was scored by using the Antidepressant Treatment History Form.
  
  
  RESULTS
  A large majority of the depressed patients with a history of suicide attempts, who were at higher risk for future suicide and suicide attempts, received inadequate treatment. Similarly, most of the depressed patients at lower risk for suicide attempts also received inadequate treatment.
  
  
  CONCLUSIONS
  Major depression is undertreated pharmacologically, regardless of history of suicide attempt. Some suicide attempts may be preventable if the problem of underdiagnosis and undertreatment of depression can be overcome by psychoeducation for health professionals and the public.
authors.affiliation: Mental Health Clinical Research Center for the Study of Suicidal Behavior, Department of Neuroscience, New York State Psychiatric Institute, New York 10032, USA. moquendo@neuron.cpmc.columbia.edu
authors.forename: M A
authors.initials: MA
authors.lastname: Oquendo
authors.forename: K M
authors.initials: KM
authors.lastname: Malone
authors.forename: S P
authors.initials: SP
authors.lastname: Ellis
authors.forename: H A
authors.initials: HA
authors.lastname: Sackeim
authors.forename: J J
authors.initials: JJ
authors.lastname: Mann
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004334:Drug Administration Schedule; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*; D016896:Treatment Outcome