Family history of completed suicide and characteristics of major depressive disorder: a STAR*D (sequenced treatment alternatives to relieve depression) study.
BACKGROUND
Clinicians routinely ask patients with non-psychotic major depressive disorder (MDD) about their family history of suicide. It is unknown, however, whether patients with a family member who committed suicide differ from those without such a history.


METHODS
Patients were recruited for the STAR*D multicenter trial. At baseline, patients were asked to report first-degree relatives who had died from suicide. Differences in demographic and clinical features for patients with and without a family history of suicide were assessed.


RESULTS
Patients with a family history of suicide (n=142/4001; 3.5%) were more likely to have a family history of MDD, bipolar disorder, or any mood disorder, and familial substance abuse disorder, but not suicidal thoughts as compared to those without such a history. The group with familial suicide had a more pessimistic view of the future and an earlier age of onset of MDD. No other meaningful differences were found in depressive symptoms, severity, recurrence, depressive subtype, or daily function.


CONCLUSIONS
A history of completed suicide in a family member was associated with minimal clinical differences in the cross-sectional presentation of outpatients with MDD. Limitations of the study include lack of information about family members who had attempted suicide and the age of the probands when their family member died. STAR*D assessments were limited to those needed to ascertain diagnosis and treatment response and did not include a broader range of psychological measures.
Nierenberg
Andrew A
AA
Depression Clinical and Research Program, Massachusetts General Hospital Harvard Medical School, Boston, MA 01224, USA. anierenberg@partners.org
Alpert
Jonathan E
JE
Gaynes
Bradley N
BN
Warden
Diane
D
Wisniewski
Stephen R
SR
Biggs
Melanie M
MM
Trivedi
Madhukar H
MH
Barkin
Jennifer L
JL
Rush
A John
AJ
D000328:Adult; D017668:Age of Onset; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology / Q000628:therapy; D015283:Citalopram / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology / Q000628:therapy; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology / Q000628:therapy; D012008:Recurrence; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram