Do major depressive disorder and dysthymic disorder confer differential risk for suicide?
BACKGROUND
Although there has been a tremendous amount of research examining the risk conferred for suicide by depression in general, relatively little research examines the risk conferred by specific forms of depressive illness (e.g., dysthymic disorder, single episode versus recurrent major depressive disorder [MDD]). The purpose of the current study was to examine differences in suicidal ideation, clinician-rated suicide risk, suicide attempts, and family history of suicide in a sample of outpatients diagnosed with various forms of depressive illness.


METHODS
To accomplish this aim, we conducted a cluster analysis using the aforementioned suicide-related variables in a sample of 494 outpatients seen between January 2001 and July 2007 at the Florida State University Psychology Clinic. Patients were diagnosed using DSM-IV criteria.


RESULTS
Two distinct clusters emerged that were indicative of lower and higher risk for suicide. After controlling for the number of comorbid Axis I and Axis II diagnoses, the only depressive illness that significantly predicted cluster membership was recurrent MDD, which tripled an individual's likelihood of being assigned to the higher risk cluster.


CONCLUSIONS
The use of a cross-sectional design; the relatively low suicide risk in our sample; the relatively small number of individuals with double depression.


CONCLUSIONS
Our results demonstrate the importance of both chronicity and severity of depression in terms of predicting increased suicide risk. Among the various forms of depressive illness examined, only recurrent MDD appeared to confer greater risk for suicide.
Witte
Tracy K
TK
Florida State University, Department of Psychology, 32306-4301, United States. witte@psy.fsu.edu
Timmons
Katherine A
KA
Fink
Erin
E
Smith
April R
AR
Joiner
Thomas E
TE
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D016000:Cluster Analysis; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005431:Florida; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012008:Recurrence; D018570:Risk Assessment / Q000706:statistics & numerical data; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult