title: A history of major depressive disorder influences intent to die in violent suicide attempters.
abstract: BACKGROUND
  The inconsistency of the results obtained in biological studies of suicidal behavior may be due to the use of broad categories lacking validity. In previous genetic studies, in which we identified an association between a serotonin-related gene and violent suicide attempts, we suggested that a history of major depressive disorder (MDD) might influence this association. In this study, we aimed to clarify the relationships between the violence of suicide attempts, intent to die, and depression in a large sample of suicide attempters.
  
  
  METHODS
  We investigated intent to die, according to history of violent suicide attempts and MDD, in 502 consecutively admitted suicide attempters. We characterized patients in terms of lifetime DSM-IV Axis I diagnoses, suicidal intent (Beck Suicide Intent Scale), and history of violent suicide attempts.
  
  
  RESULTS
  Suicidal intent, for both the last suicide attempt before admission and the most lethal suicide attempt, was higher in those with history of MDD (p =.03 and p =.04, respectively) but was not affected by history of violent suicide attempt. In violent suicide attempters, suicidal intent was higher in patients with a history of MDD than in patients with no such history (p =.04 for last suicide attempt and p =.02 for most lethal attempt), whereas MDD had no effect on suicidal intent in nonviolent suicide attempters.
  
  
  CONCLUSIONS
  Violent suicide attempters constitute a heterogeneous group in terms of suicidal intent. Our results suggest that biological and genetic studies should take into account the method used to attempt suicide, intent to die, and history of MDD.
authors.affiliation: Department of Psychological Medicine and Psychiatry, Lapeyronie Hospital, CHU Montpellier, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Astruc
authors.forename: Stephane
authors.initials: S
authors.lastname: Torres
authors.forename: Fabrice
authors.initials: F
authors.lastname: Jollant
authors.forename: Sophie
authors.initials: S
authors.lastname: Jean-Baptiste
authors.forename: Didier
authors.initials: D
authors.lastname: Castelnau
authors.forename: Alain
authors.initials: A
authors.lastname: Malafosse
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
mesh_terms: D000328:Adult; D000367:Age Factors; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006760:Hospitalization; D006801:Humans; D033182:Intention; D008297:Male; D008487:Medical History Taking; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D014754:Violence / Q000523:psychology*