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Presence of suicidality as a prognostic indicator
K Malhotra1, T Schwartz, U Hameed
1Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
Background:
Suicidal symptoms in depression are often thought to predict a higher severity of illness and a worse prognosis.
Aims:
To determine if suicidal ideation at the time of treatment for major depression can predict response to antidepressant medication in primary care.
Settings And Design:
A retrospective analysis of subjects receiving anti-depressant drugs in a primary care setting
Methods And Material:
Nine depressed patients (14%) who acknowledged suicidality on the PHQ-9 depression scale were followed up for and compared to a group of 54 (86%) depressed patients (controls) who did not have suicidal thoughts for four months. All were given treatment with antidepressants and followed with a disease management protocol where the PHQ-9 was used as a systematic outcome measure.
Statistical Analysis:
Descriptive measures and t-tests were utilized to show statistical significance.
Results:
There were no statistical differences in remission from depressive symptoms based on the PHQ-9 scale after antidepressant treatment, between patients with suicidal thoughts (56%) and those without (44%).
Conclusion:
The presence of suicidality as a depressive symptom did not predict poorer clinical outcome when treating depression in the primary care setting in the patients studied.