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Intermittent 3-day depressions and suicidal behaviour
S A Montgomery1, D Montgomery, D Baldwin
1St Mary's Hospital, London, UK.
Neuropsychobiology
|January 1, 1989
Summary
Recurrent suicidal attempters experienced brief, severe depressive episodes lasting around 3 days. These unpredictable mood shifts occurred frequently, highlighting a distinct pattern in this patient group.
Area of Science:
- Psychiatry
- Clinical Psychology
Background:
- Borderline personality disorder (BPD) is often misdiagnosed in patients with recurrent suicidal behaviors.
- Understanding the specific depressive episodes in these individuals is crucial for accurate diagnosis and treatment.
Purpose of the Study:
- To characterize the nature of intermittent depressive episodes in recurrent suicidal attempters without major depression.
- To investigate the duration, frequency, and severity of these mood episodes.
Main Methods:
- Prospective follow-up of 20 recurrent suicidal attempters over 4-6 months.
- Assessment of depressive episodes using the Montgomery-Åsberg Depression Rating Scale (MADRS).
Main Results:
- Depressive episodes were short-lived, with a median duration of 3 days (two-thirds lasting 2-4 days).
- Episodes occurred unpredictably with a median interval of 18 days.
- 70% of episodes were rated as moderate to severe on the MADRS.
Conclusions:
- The study identifies a pattern of brief, severe, and unpredictable depressive episodes in recurrent suicidal attempters.
- These findings challenge the frequent misclassification of such patients as having borderline personality disorder.
- Further research is needed to refine diagnostic criteria and treatment strategies for this population.