Decline in suicidal ideation among patients with MDD is preceded by decline in depression and hopelessness.
BACKGROUND
Suicidal ideation is likely to represent a phase preceding suicidal acts among most suicidal patients with major depressive disorder (MDD). Factors predicting reversal of the suicidal process are unknown. Our aim was to test the hypothesis that a decline in suicidal ideation is preceded by a decline in hopelessness among patients with MDD.


METHODS
Of the 269 Vantaa Depression Study patients with DSM-IV MDD, 103 patients scored > or = 6 points at baseline on the Scale for Suicidal Ideation (SSI). Seventy of these patients were followed-up weekly either until they scored zero points on the SSI, or up to 26 weeks.


RESULTS
The median duration for a decline of suicidal ideation to zero was 2.2 months after baseline. The level of baseline suicidal ideation, depressive symptoms, and the presence of any personality disorder predicted duration of suicidal ideation. A decline in both depression (BDI) and hopelessness (HS) independently predicted a decline in suicidal ideation.


CONCLUSIONS
Due to study design, we do not know if suicidal ideation relapsed after the first time the patient reached zero score in the SSI.


CONCLUSIONS
Among patients with major depressive disorder having suicidal ideation, the decline in suicidal ideation is independently predicted by preceding declines in the levels of both depressive symptoms as well as hopelessness. The findings are consistent with possible causal roles of declines in depression and hopelessness in reversing the suicidal process.
Sokero
Petteri
P
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Eerola
Mervi
M
Rytsälä
Heikki
H
Melartin
Tarja
T
Leskelä
Ulla
U
Lestelä-Mielonen
Paula
P
Isometsä
Erkki
E
D000339:Affect; D003865:Major Depressive Disorder / Q000523:psychology*; D005387:Finland; D006801:Humans; D053208:Kaplan-Meier Estimate; D016016:Proportional Hazards Models; D012074:Remission Induction; D012307:Risk Factors; D013405:Suicide / Q000523:psychology*