History of suicide attempts among patients with depression in the GENDEP project

• Published in: Journal of affective disorders Vol. 123; no. 1-3; pp. 131 - 137
• Main Authors: Perroud, Nader, Uher, Rudolf, Hauser, Joanna, Rietschel, Marcella, Henigsberg, Neven, Placentino, Anna, Kozel, Dejan, Maier, Wolfgang, Mors, Ole, Souery, Daniel, Dmitrzak-Weglarz, Monika, Jorgensen, Lisbeth, Kovacic, Zrnka, Giovannini, Caterina, Mendlewicz, Julien, Zobel, Astrid, Strohmaier, Jana, McGuffin, Peter, Aitchison, Katherine J., Farmer, Anne
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01.06.2010; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Antidepressant drugs; Antidepressive Agents, Second-Generation - adverse effects; Antidepressive Agents, Second-Generation - therapeutic use; Antidepressive Agents, Tricyclic - adverse effects; Antidepressive Agents, Tricyclic - therapeutic use; Biological and medical sciences; Citalopram - adverse effects; Citalopram - therapeutic use; Comorbidity; Demographic aspects; Depression; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Depressive personality disorders; Escitalopram; Europe; Female; Follow-Up Studies; Humans; Male; Medical sciences; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - psychology; Middle Aged; Mood disorders; Neuropharmacology; Nortriptyline; Nortriptyline - adverse effects; Nortriptyline - therapeutic use; Personality Assessment; Pharmacology. Drug treatments; Psychiatry; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Risk Factors; Suffering; Suicidal behaviour; Suicide; Suicide attempts; Suicide, Attempted - psychology; Suicide, Attempted - statistics & numerical data; Europe; Suicide attempts; Nortriptyline; Depression; Escitalopram; Mood disorder; Human; Serotonin; Psychotropic; Tricyclic compound; Reuptake inhibitor; History; Selective serotonin reuptake inhibitor; Suicide attempt; Neurotransmitter; Antidepressant agent
• ISSN: 0165-0327; 1573-2517; 1573-2517
• DOI: 10.1016/j.jad.2009.09.001

It has been proposed that a history of suicide attempts could be a correlate of severe depressive disorder and that suicide attempters (SA) could represent a particular subtype of subjects suffering from major depressive disorder. We investigated clinical and demographic characteristics associated with SA and tested the hypothesis that a history of suicide attempts predicts poor response to antidepressants. One-hundred-and-forty-one SA and 670 non-SA subjects with major depressive disorder (MDD) were treated for twelve weeks with escitalopram or nortriptyline in GENDEP, a part-randomized multi-center clinical and pharmacogenetic study. Baseline characteristics were compared using linear and logistic regression. Linear mixed models were used to analyse continuous outcomes during the twelve weeks of follow-up. At baseline, SA subjects suffered from more severe depression (mean Montgomery-Asberg Depression Rating Scale: 30.29 (7.61) vs 28.43 (6.54), p=0.0002), reported higher level of suicidal ideation (1.21 (0.82) vs 0.73 (0.48), p<0.0001), had a younger age of onset and experienced more depressive episodes, had higher harm avoidance scores and poorer socio-demographic environment than non-SA individuals. However, during the twelve weeks of treatment and after adjustment for baseline severity of depression there was no difference in treatment response between SA and non-SA. Due to its retrospective design, it is possible that more severely depressed subjects might report more suicide attempts than less depressed individuals. While SA differed from non-SA in several clinical and demographic characteristics, the antidepressants were similarly effective in SA as in comparably severely depressed subjects without a history of suicide attempts.