title: Persistence and resolution of suicidal ideation during treatment of depression in patients with significant suicidality at the beginning of treatment: the CRESCEND study.
abstract: BACKGROUND
  The appropriate length of time for patients who visit clinics with significant suicidal ideation to be closely monitored is a critical issue for clinicians. We evaluated the course of suicidal ideation and associated factors for persistent suicidality in patients who entered treatment for depression with significant suicidal ideation.
  
  
  METHODS
  A total of 565 patients who had both moderate to severe depression (Hamilton Depression Rating Scale (HAMD) score ≥14) and significant suicidal ideation (Beck Scale for Suicide Ideation (SSI-B) score ≥6) were recruited from 18 hospitals in South Korea. Participants were assessed using the SSI-B, HAMD, Hamilton Anxiety Rating Scale, and Clinical Global Impression Scale-severity during a 12-week naturalistic treatment with antidepressant intervention. Participants were classified into resolved suicidality or persistent suicidality groups according to whether their suicidal ideation improved to SSI-B scores <6 and were sustained for 12 weeks.
  
  
  RESULTS
  During the 12-week treatment, 206 (36.4%) patients were classified in the resolved suicidality group. Persistent suicidality was associated with intervention with SSRIs, higher SSI-B baseline score, and no HAMD or HAMA remission. The proportions of participants who had persistent suicidal ideation even with HAMD remission or response were 0.25 and 0.34, respectively.
  
  
  CONCLUSIONS
  This study was observational, and the treatment modality was naturalistic.
  
  
  CONCLUSIONS
  A considerable number of patients had persistent suicidal ideation despite 12 weeks of antidepressant treatment. Close monitoring for suicidal ideation may be needed beyond the initial weeks of treatment and even after a response to antidepressants is observed.
authors.affiliation: Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea; Clinical Research Center for Depression, Seoul, Republic of Korea.
authors.forename: Ho-Jun
authors.initials: HJ
authors.lastname: Seo
authors.affiliation: Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea; Clinical Research Center for Depression, Seoul, Republic of Korea.
authors.forename: Young-Eun
authors.initials: YE
authors.lastname: Jung
authors.affiliation: Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Clinical Research Center for Depression, Seoul, Republic of Korea.
authors.forename: Seunghee
authors.initials: S
authors.lastname: Jeong
authors.affiliation: Department of Psychiatry, Keimyung University, School of Medicine, Daegu, Republic of Korea; Clinical Research Center for Depression, Seoul, Republic of Korea.
authors.forename: Jung-Bum
authors.initials: JB
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea; Clinical Research Center for Depression, Seoul, Republic of Korea.
authors.forename: Min-Soo
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Kwangju, Republic of Korea; Clinical Research Center for Depression, Seoul, Republic of Korea.
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Clinical Research Center for Depression, Seoul, Republic of Korea.
authors.forename: Hyeon Woo
authors.initials: HW
authors.lastname: Yim
authors.affiliation: Department of Psychiatry, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul Republic of Korea; Clinical Research Center for Depression, Seoul, Republic of Korea. Electronic address: tyjundepression@gmail.com.
authors.forename: Tae-Youn
authors.initials: TY
authors.lastname: Jun
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D056910:Republic of Korea; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Depression; Persistent suicidality; Predictive factor; Resolved suicidality; Suicide ideation