Parasuicide and depression: a comparison of clinical and questionnaire diagnoses

The frequency with which depressive disorder is diagnosed in parasuicide varies. It has been suggested that when observer bias is removed and a depression questionnaire employed, a greater number of young women who attempt suicide will be designated as depressed than would be expected on the basis of previous clinical reports. Our study compared clinical diagnoses made according to Feighner's research diagnostic criteria or DSM III with the categorisations obtained by the Levine-Pilowsky Depression questionnaire (LPD). Fifty-one patients, 34 female and 17 male, were studied, 31.4% having a primary Major Depressive Disorder and 23.5% secondary depression as clinical diagnoses. The LPD categorised 72.5% as depressed. Comparison of the clinical diagnoses with questionnaire data suggests that the LPD is overinclusive and not as specific as clinical diagnosis. Alcohol and substance abuse disorders accounted for almost one-third of the diagnoses and are therefore an important concomitant of parasuicide.