A comparison of the clinical characteristics of women with recurrent major depression with and without suicidal symptomatology

Abstract

BackgroundThe relationship between recurrent major depression (MD) in women and suicidality is complex. We investigated the extent to which patients who suffered with various forms of suicidal symptomatology can be distinguished from those subjects without such symptoms.MethodWe examined the clinical features of the worst episode in 1970 Han Chinese women with recurrent DSM-IV MD between the ages of 30 and 60 years from across China. Student's t tests, and logistic and multiple logistic regression models were used to determine the association between suicidality and other clinical features of MD.ResultsSuicidal symptomatology is significantly associated with a more severe form of MD, as indexed by both the number of episodes and number of MD symptoms. Patients reporting suicidal thoughts, plans or attempts experienced a significantly greater number of stressful life events. The depressive symptom most strongly associated with lifetime suicide attempt was feelings of worthlessness (odds ratio 4.25, 95% confidence interval 2.9–6.3). Excessive guilt, diminished concentration and impaired decision-making were also significantly associated with a suicide attempt.ConclusionsThis study contributes to the existing literature on risk factors for suicidal symptomatology in depressed women. Identifying specific depressive symptoms and co-morbid psychiatric disorders may help improve the clinical assessment of suicide risk in depressed patients. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicide.

Clarifying the role of neuroticism in suicidal ideation and suicide attempt among women with major depressive disorder

“…Participant age ranged from 30 to 60; MD participants tended to be younger ( M = 44.44, SD = 8.94) than control participants ( M = 47.68, SD = 5.59), t (9824) = 23.47, p < 2.2E-16. Other demographic information on the sample, including those participants who reported suicidality, is provided elsewhere (Yang et al 2011; Bi et al 2012; Gan et al 2012; Zhu et al 2013). …”

“…However, given the consistent association of psychopathology (e.g., depression) with suicidal ideation and attempt (Beautrais 1999), it is imperative that research adjust for comorbid diagnoses to avoid conflating suicidal ideation and attempt with related psychopathological syndromes. Similarly, Kendler and colleagues, among others, have demonstrated the role of stressful life events in suicidal ideation and behavior, specifically attempted suicide (Statham et al 1998; Fergusson et al 2000; Roy 2003a, 2003a; Fanous et al 2004; Bi et al 2012; Fang et al 2012; Zhu et al 2013; Chan et al 2014). Neuroticism may increase the risk to experience stressful life events or to perceive life events as stressful (Kendler et al 2003; Pickles et al 2010).…”

“…While much of the research in this area does not address the potential confound of diagnosis, many do adjust for comorbid internalizing disorders (Naragon-Gainey & Watson 2011; Batterham & Christensen 2012) and stressful life events (Statham et al 1998; Fergusson et al 2000, 2003; Farmer et al 2001; Fanous et al 2004; Pickles et al 2010; Bi et al 2012; Zhu et al 2013). Research that adjusts for comorbid diagnoses generally confirms the association of suicidal ideation with elevated neuroticism (though see Vrshek-Schallhorn et al 2011).…”

“…However, only a fraction of studies on the association between neuroticism and attempted suicide have adjusted for stressful life events. Among studies that adjust for stressful life events, the majority also adjust for comorbid psychopathology and do not find evidence of an association between neuroticism and attempted suicide (Fergusson et al 2000; Bi et al 2012; Fang et al 2012; Zhu et al 2013; Chan et al 2014), though results are mixed (Statham et al 1998; Fergusson et al 2003). …”

The relationship between self-disgust, guilt, and flow experience among Japanese undergraduates

“…In a previous study, excessive guilt was found to be significantly associated with suicide attempt 9. In Japan, out of 18,104 students (8,620 were 12–15 years of age; 9,484 were 15–18 years of age), 276 (3.3%) of the junior and 396 (4.3%) of the senior high school students reported to have self-harmed 10.…”