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Suicidal behaviour among primary-care patients with depressive disorders
M S Vuorilehto1, T K Melartin, E T Isometsä
1Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Psychological Medicine
|January 20, 2006
Summary
Many primary care patients with depression consider or attempt suicide. High-risk groups, including those with personality disorders or prior psychiatric care, need focused prevention strategies for suicidal behavior.
Area of Science:
- Psychiatry
- Public Health
- Primary Care Medicine
Background:
- National suicide prevention strategies emphasize depression management in primary care.
- Suicidal behavior in primary care patients with depression remains understudied.
Purpose of the Study:
- To investigate the prevalence and predictors of suicidal behavior among primary care patients diagnosed with depressive disorders.
Main Methods:
- Screened 1119 primary care patients for depression using PRIME-MD.
- Diagnosed depressive disorders with SCID-I in 137 patients.
- Assessed suicidal behavior (ideation, attempts) cross-sectionally and retrospectively using SSI, interviews, and records.
Main Results:
- 37% of patients considered suicide, and 17% attempted suicide in their lifetime.
- Lifetime suicidal behavior predicted by psychiatric history and comorbid personality disorder.
- Current episode suicidal behavior strongly predicted by depression severity.
Conclusions:
- Primary care suicide prevention should target high-risk depressed patients (moderate-severe MDD, personality disorder, prior psychiatric care).
- Improved recognition of suicidal behavior is crucial.
- Tailoring preventive efforts to complex psychopathology in primary care is necessary.
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