title: Melancholic features and hostility are associated with suicidality risk in Asian patients with major depressive disorder.
abstract: BACKGROUND
  Suicide rates are higher in East-Asians than other populations, and especially high in Koreans. However, little is known about suicidality risk and melancholic features in Asian patients with major depressive disorder (MDD).
  
  
  METHODS
  Drug-free MDD outpatients were included from 13 centers across five ethnicities consisting of Chinese (n=290), Korean (n=101), Thai (n=102), Indian (n=27), and Malay (n=27). All were interviewed using the Mini-International Neuropsychiatric Interview (M.I.N.I.), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Symptoms Checklist 90-Revised (SCL-90-R).
  
  
  RESULTS
  Of 547 subjects, 177 MDD patients showed melancholic features (32.4%). These melancholic MDD patients revealed significantly higher suicidality risk (p<0.0001), hostility (p=0.037), and severity of depression (p<0.0001) than those MDD patients without melancholic features. Suicidality risk was significantly higher in MDD with melancholic features than those without in subjects with lower hostility, whereas it showed no difference in higher hostility. Adjusted odds ratios of melancholic features and hostility for moderate to high suicidality risk were 1.79 (95% CI=1.15-2.79) and 2.45 (95% CI=1.37-4.38), after adjusting for age, sex, education years, and depression severity. Post-hoc analyses showed that suicidality risk was higher in Korean and Chinese than that of Thai, Indian and Malay in MDD subjects with melancholic features, although depression severity showed no significant differences among the ethnicities.
  
  
  CONCLUSIONS
  Suicidality risk is associated with both melancholic features and hostility and it shows cross-ethnic differences in Asian MDD patients, independent of depression severity.
authors: Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: Hong Jin
authors: HJ
authors: Jeon
authors: Daihui
authors: D
authors: Peng
authors: Hong Choon
authors: HC
authors: Chua
authors: Manit
authors: M
authors: Srisurapanont
authors: Maurizio
authors: M
authors: Fava
authors: Jae-Nam
authors: JN
authors: Bae
authors: Sung
authors: S
authors: Man Chang
authors: Jin Pyo
authors: JP
authors: Hong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000208:ethnology* / Q000523:psychology*; D005260:Female; D006791:Hostility; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012720:Severity of Illness Index; D013405:Suicide / Q000208:ethnology* / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult