Prospective study of risk factors for attempted suicide among patients with DSM-IV major depressive disorder.
BACKGROUND
There are few prospective studies on risk factors for attempted suicide among psychiatric out- and in-patients with major depressive disorder.


OBJECTIVE
To investigate risk factors for attempted suicide among psychiatric out- and in-patients with major depressive disorder in the city of Vantaa, Finland.


METHODS
The Vantaa Depression Study included 269 patients with DSM-IV major depressive disorder diagnosed using semistructured interviews and followed up at 6- and 18-month interviews with a life chart.


RESULTS
During the 18-month followup, 8% of the patients attempted suicide. The relative risk of an attempt was 2.50 during partial remission and 7.54 during a major depressive episode, compared with full remission (P 0.001). Numerous factors were associated with this risk, but lacking a partner, previous suicide attempts and total time spent in major depressive episodes were the most robust predictors.


CONCLUSIONS
Suicide attempts among patients with major depressive disorder are strongly associated with the presence and severity of depressive symptoms and predicted by lack of partner, previous suicide attempts and time spent in depression. Reducing the time spent depressed is a credible preventive measure.
Sokero
T Petteri
TP
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Melartin
Tarja K
TK
Rytsälä
Heikki J
HJ
Leskelä
Ulla S
US
Lestelä-Mielonen
Paula S
PS
Isometsä
Erkki T
ET
D000328:Adult; D000704:Analysis of Variance; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data