title: Does early improvement in major depression protect against treatment emergent suicidal ideation?
abstract: OBJECTIVE
  To investigate the association of early improvement and treatment emergent suicidal ideation in a large sample (N=705) of naturalistically treated inpatients with major depressive disorder.
  
  
  METHODS
  In line with previous reports early improvement was defined as a 20% HAMD improvement within the first two weeks of antidepressant treatment. Treatment emergent suicidal ideation was defined by a sudden increase from 0 or 1 to at least 3 on HAMD item 3 and from 0.1 to at least 4 on MADR item 10 for suicidal ideation. Early improvers were compared with non-early improvers with respect to the occurrence of treatment emergent suicidality during treatment.
  
  
  RESULTS
  Early improvers were 3 (MADRS) to 3.4 (HAMD) times less likely to experience new emergence of suicidal ideation during the treatment course than non-improvers. In addition, early improvement was associated with significantly less pessimistic thoughts.
  
  
  CONCLUSIONS
  The analysis is based on secondary analysis of prospectively collected data. No controlled study design.
  
  
  CONCLUSIONS
  Early improvement is associated with significantly less treatment emergent suicidal ideation for it may provide rapid symptom relief and reduce hopelessness.
authors.affiliation: Department of Psychiatry, Ludwig Maximilians University, Nussbaumstr. 7, Munich, Germany. florian.seemueller@med.uni-muenchen.de
authors.forename: Florian
authors.initials: F
authors.lastname: Seemüller
authors.forename: Rebecca
authors.initials: R
authors.lastname: Schennach-Wolff
authors.forename: Michael
authors.initials: M
authors.lastname: Obermeier
authors.forename: Verena
authors.initials: V
authors.lastname: Henkel
authors.forename: Hans Jürgen
authors.initials: HJ
authors.lastname: Möller
authors.forename: Michael
authors.initials: M
authors.lastname: Riedel
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage; D000928:Antidepressive Agents / Q000008:administration & dosage*; D018692:Antimanic Agents / Q000008:administration & dosage; D014150:Antipsychotic Agents / Q000008:administration & dosage; D001294:Attitude to Health; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016651:Lithium Carbonate / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011594:Psychometrics; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology; D014149:Tranquilizing Agents / Q000008:administration & dosage
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D014149:Tranquilizing Agents; D016651:Lithium Carbonate