Predictors of suicidal ideation in depressive primary care patients.
BACKGROUND
Suicidal ideation is common in patients suffering from depression, but it often remains undetected. General practitioners play an important role in the management of depression and suicidality. The aim of this study was to identify predictors for suicidal ideation in patients with major depression in primary health care.


METHODS
We conducted a cross-sectional study. Patients were recruited from 74 primary care practices in Germany. Data was collected between April 2005 and July 2006. We calculated a binary logistic regression model to evaluate whether depression severity (Patient Health Questionnaire, PHQ-9), physical pain (SF-36 Physical Pain Scale), physical comorbidity, intake of antidepressant medication, sex and age were predictors of suicidal ideation.


RESULTS
We enrolled 626 patients, aged 18 to 80 with major depression. Depression severity (OR 1.16 per unit PHQ-9 score, 95% CI 1.09-1.22, p<0.001) and male sex (OR 1.71, 95% CI 1.13-2.58, p=0.012) were associated with suicidal ideation, while absence of pain (OR 0.99 per unit SF-36 Physical Pain Scale, 95% CI 0.98-1.00, p=0.004) and older age (>60) compared to the reference group aged 40 to 60 (OR 0.55, 95% CI 0.35-0.86, p=0.009) were protective factors.


CONCLUSIONS
This cross-sectional study allows the generation of hypotheses.


CONCLUSIONS
Depression severity is a predictor for suicidal ideation in primary care patients with major depression. In addition, physical pain appears to be a predictor. Results should be confirmed using a prospective study design.
Gensichen
Jochen
J
Institute for General Practice, Friedrich-Schiller University Jena, Germany. jochen.gensichen@med.uni-jena.de
Teising
Anna
A
König
Jochem
J
Gerlach
Ferdinand M
FM
Petersen
Juliana J
JJ
D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011320:Primary Health Care; D011594:Psychometrics; D012307:Risk Factors; D059020:Suicidal Ideation; D055815:Young Adult