title: Suicidal behaviours in adjustment disorder and depressive episode.
abstract: BACKGROUND
  Little is known about suicidal ideation and behaviours in adjustment disorder (AD). In this paper we sought to examine the variables independently associated with suicidal ideation and behaviour in patients diagnosed with AD or depressive (DE) episode among psychiatric outpatients and in liaison psychiatry.
  
  
  METHODS
  370 patients who were referred to the liaison psychiatry services (including those seen in the Emergency Department) at 3 Dublin hospitals, and were clinically diagnosed with either DE or AD, based on the ICD 10 diagnostic criteria, were recruited to the study. We examined their demographic and clinical characteristics, and the associations between these and suicidal ideation and behaviour on multivariate analysis.
  
  
  RESULTS
  Younger age, single marital status, and greater severity of depressive symptoms were significantly associated with suicidality across both diagnoses. On multivariate analysis, greater severity of depressive symptoms was associated with suicidality in those with AD (p=0.012) and DE (p=0.009). Those with AD exhibited suicidality at lower symptom scores than did those with DE but in both groups it still occurred at the highest level of severity. There were differences in the objective circumstances measure of suicide intent.
  
  
  CONCLUSIONS
  We used clinical diagnosis rather as the main diagnostic classification. The generalisability of this paper may be limited to consultation-liaison psychiatry settings, where suicidal ideation and behaviours are common.
  
  
  CONCLUSIONS
  Suicidality in AD and DE has broadly similar risk factors but differ in aspects of suicide intent. Different mechanisms may underpin suicidality in those with AD compared to DE.
authors.affiliation: Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland. Electronic address: apsych@mater.ie.
authors.forename: Patricia
authors.initials: P
authors.lastname: Casey
authors.affiliation: Community Outreach and Assertive Services Team, Department of Psychiatry, University Hospital of Northern British Columbia, 1444 Edmonton Street, Prince George, BC, Canada V2M6W5.
authors.forename: Faraz
authors.initials: F
authors.lastname: Jabbar
authors.affiliation: NCRI, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland.
authors.forename: Eamonn
authors.initials: E
authors.lastname: O'Leary
authors.affiliation: King׳s College Hospital, Denmark Hill, London SE5 9RS, United Kingdom. Electronic address: anne.doherty@kcl.ac.uk.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Doherty
mesh_terms: D000275:Adjustment Disorders / Q000523:psychology*; D000328:Adult; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D055815:Young Adult
keywords: Adjustment disorder; Depressive episode; Liaison psychiatry; Self-harm; Suicidal ideation