Characteristics and treatment outcome of suicidal depression: Two large naturalistic cohorts of depressed outpatients
Abstract : Objective: The
emergence of new drugs for managing suicidal ideation (e.g. ketamine)
raises the question of whether suicidal depression (i.e. moderate to
severe depression with concomitant suicidal ideation) is a specific
depression phenotype. Therefore, this study characterized patients with
suicidal depression (baseline clinical characteristics, suicidal
ideation and depression evolutions, suicide risk) in two large cohorts
of outpatients with depression.
Methods: LUEUR and GENESE are two large, prospective, naturalistic
cohorts of French adult outpatients with depression (Diagnostic and
Statistical Manual of Mental Disorders, fourth edition, criteria),
treated and followed up for 6 weeks. Depression severity was assessed
with the Hospital Anxiety and Depression Scale, and suicidal ideation
with the suicidal item of the Montgomery-Åsberg Depression Rating Scale.
Patients with moderate or severe depression (Hospital Anxiety and
Depression Scale-Depression subscale score >11) were selected and
classified as without suicidal ideation (suicidal item of the
Montgomery-Åsberg Depression Rating Scale <2), with moderate suicidal
ideation (suicidal item of the Montgomery-Åsberg Depression Rating
Scale [2; 3]) and with severe suicidal ideation (suicidal item of the
Montgomery-Åsberg Depression Rating Scale ⩾4).
Results: Baseline clinical features were more severe (e.g. higher
anxiety and depression scores) in depressed patients with
moderate/severe suicidal ideation. Depression remission after treatment
was less frequent among patients with severe suicidal ideation. The risk
of suicide attempt during the follow-up was threefold higher in
patients with suicidal ideation among those 10% had persistent suicidal
ideation.
Conclusion: Suicidal depression could be a specific depression phenotype
with more severe clinical characteristics, less frequent depression
remission, suicidalideation persistence and higher suicide attempt risk, despite antidepressant treatment. It seems that
Soumis le : mercredi 21 juillet 2021 - 15:28:44
Dernière modification le : vendredi 23 juillet 2021 - 03:15:43
Source https://hal.archives-ouvertes.fr/hal-03294347
Soumis le : mercredi 21 juillet 2021 - 15:28:44
Dernière modification le : vendredi 23 juillet 2021 - 03:15:43
Source https://hal.archives-ouvertes.fr/hal-03294347