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The prospectively observed course of illness among depressed patients who commit suicide
William Coryell1, James Haley, Jean Endicott
1Department of Psychiatry, University of Iowa, Iowa City 52242-1000, USA. william-coryell@uiowa.edu
Objective:
These analyses were conducted to describe the course of illness among patients with major affective disorders who commit suicide.
Method:
Twenty-nine patients who entered a long-term, high-intensity follow-up study of major affective disorders and who later committed suicide within 1 year of their last follow-up interview were individually matched to other patients by age, sex, the presence or absence of lifetime drug or alcohol abuse, time to last interview and polarity. Those who suicided were compared with their controls by depressive and substance abuse morbidity during follow-up, treatment resistance, treatment compliance, suicidal behavior and psychosocial adjustment.
Results:
Among the various measures used to characterize the course of illness during a mean follow-up of 4.3 years, only those pertaining to suicidal behavior robustly separated the suicide group from their controls. Suicidal behavior in the remote past seemed as predictively important as suicidal behavior during follow-up.
Conclusion:
Of the various features monitored over time in patients with major affective disorder, suicidal behavior itself was the clearest correlate of risk for completed suicide.