title: History of suicide attempts among patients with depression in the GENDEP project.
abstract: BACKGROUND
  It has been proposed that a history of suicide attempts could be a correlate of severe depressive disorder and that suicide attempters (SA) could represent a particular subtype of subjects suffering from major depressive disorder. We investigated clinical and demographic characteristics associated with SA and tested the hypothesis that a history of suicide attempts predicts poor response to antidepressants.
  
  
  METHODS
  One-hundred-and-forty-one SA and 670 non-SA subjects with major depressive disorder (MDD) were treated for twelve weeks with escitalopram or nortriptyline in GENDEP, a part-randomized multi-center clinical and pharmacogenetic study. Baseline characteristics were compared using linear and logistic regression. Linear mixed models were used to analyse continuous outcomes during the twelve weeks of follow-up.
  
  
  RESULTS
  At baseline, SA subjects suffered from more severe depression (mean Montgomery-Asberg Depression Rating Scale: 30.29 (7.61) vs 28.43 (6.54), p=0.0002), reported higher level of suicidal ideation (1.21 (0.82) vs 0.73 (0.48), p<0.0001), had a younger age of onset and experienced more depressive episodes, had higher harm avoidance scores and poorer socio-demographic environment than non-SA individuals. However, during the twelve weeks of treatment and after adjustment for baseline severity of depression there was no difference in treatment response between SA and non-SA.
  
  
  CONCLUSIONS
  Due to its retrospective design, it is possible that more severely depressed subjects might report more suicide attempts than less depressed individuals.
  
  
  CONCLUSIONS
  While SA differed from non-SA in several clinical and demographic characteristics, the antidepressants were similarly effective in SA as in comparably severely depressed subjects without a history of suicide attempts.
authors.affiliation: MRC SGDP Centre, Institute of Psychiatry at King's College London, SE5 8AF, London, United Kingdom. nader.perroud@hcuge.ch
authors.forename: Nader
authors.initials: N
authors.lastname: Perroud
authors.forename: Rudolf
authors.initials: R
authors.lastname: Uher
authors.forename: Joanna
authors.initials: J
authors.lastname: Hauser
authors.forename: Marcella
authors.initials: M
authors.lastname: Rietschel
authors.forename: Neven
authors.initials: N
authors.lastname: Henigsberg
authors.forename: Anna
authors.initials: A
authors.lastname: Placentino
authors.forename: Dejan
authors.initials: D
authors.lastname: Kozel
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Ole
authors.initials: O
authors.lastname: Mors
authors.forename: Daniel
authors.initials: D
authors.lastname: Souery
authors.forename: Monika
authors.initials: M
authors.lastname: Dmitrzak-Weglarz
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Jorgensen
authors.forename: Zrnka
authors.initials: Z
authors.lastname: Kovacic
authors.forename: Caterina
authors.initials: C
authors.lastname: Giovannini
authors.forename: Julien
authors.initials: J
authors.lastname: Mendlewicz
authors.forename: Astrid
authors.initials: A
authors.lastname: Zobel
authors.forename: Jana
authors.initials: J
authors.lastname: Strohmaier
authors.forename: Peter
authors.initials: P
authors.lastname: McGuffin
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Aitchison
authors.forename: Anne
authors.initials: A
authors.lastname: Farmer
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000627:therapeutic use; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D009661:Nortriptyline / Q000009:adverse effects / Q000627:therapeutic use; D010552:Personality Assessment; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D015283:Citalopram; D009661:Nortriptyline