title: Clinical and sociodemographic characteristics associated with suicidal ideation in depressed outpatients.
abstract: OBJECTIVE
  To identify clinical and sociodemographic characteristics associated with suicidal ideation (SI) among patients seeking care for depression in routine primary and psychiatric care settings.
  
  
  METHODS
  We examined data from 4041 treatment-seeking outpatients with major depressive disorder (MDD) to compare baseline sociodemographic and clinical characteristics of those with and without SI, and the presence or absence of baseline depressive symptoms and psychiatric comorbidities in those with SI.
  
  
  RESULTS
  SI was significantly (P < 0.01) associated with numerous sociodemographic characteristics (that is, lower level of education, Caucasian or African American, male, unemployed, and treated in psychiatric care) and clinical features (that is, previous suicide attempt, younger age of MDD onset, greater baseline depressive symptom severity, greater number of depressive symptoms, and presence of agoraphobia and [or] generalized anxiety disorder). Elevated levels of SI at baseline were associated with decreased remission rates.
  
  
  CONCLUSIONS
  Consistent with past findings, increased rates of SI were associated with greater depressive symptom severity as well as other features suggestive of severity of illness. Our results confirm previous findings of associations between SI and panic and (or) phobic symptoms and anxiety, but did not confirm previous findings of an association between SI and alcohol or drug use and (or) dependence. While selective serotonin reuptake inhibitor monotherapy appeared significantly helpful in reducing SI during the course of treatment, the presence of SI at baseline was found to be a associated with decreased treatment response, with patients reporting SI at the start of treatment being less likely to achieve remission.
  
  
  BACKGROUND
  Sequenced Treatment Alternatives to Relieve Depression, NCT00021528.
authors: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA. madhukar.trivedi@utsouthwestern.edu
authors: Madhukar H
authors: MH
authors: Trivedi
authors: David W
authors: DW
authors: Morris
authors: Stephen R
authors: SR
authors: Wisniewski
authors: Andrew A
authors: AA
authors: Nierenberg
authors: Bradley N
authors: BN
authors: Gaynes
authors: Benji T
authors: BT
authors: Kurian
authors: Diane
authors: D
authors: Warden
authors: Diane
authors: D
authors: Stegman
authors: Kathy
authors: K
authors: Shores-Wilson
authors: A John
authors: AJ
authors: Rush
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D000368:Aged; D000928:Antidepressive Agents / Q000145:classification / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000706:statistics & numerical data; D015897:Comorbidity; D003710:Demography / Q000706:statistics & numerical data; D003865:Major Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D057915:Drug Substitution / Q000379:methods / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012074:Remission Induction; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D000092864:Suicide Prevention
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors