Suicide risk in patients with somatization disorder

The aim of the study was to assess suicide risk in psychiatric outpatients with and without somatization disorder. A total sample of 120 psychiatric outpatients was used in the study, 29 of whom met diagnostic criteria for somatization disorder. The results indicated that somatization disorder was significantly associated with suicide attempts even when the effects of both a comorbid major depressive disorder and a comorbid personality disorder were statistically controlled for. The results suggest that, although a patient meets the criteria for a principal diagnosis of major depressive disorder and/or a personality disorder, it is still of significant importance to decide whether or not the patient also meets the criteria for a somatization disorder in order to more optimally assess suicide risk. The findings highlight the fact that the potential for suicide in patients with somatization disorder should not be overlooked when a diagnosable depressive disorder or personality disorder is not present.     

Suicide risk in outpatients with specific mood and anxiety disorders

The present study examined the relationships between specific anxiety, mood disorders, levels of hopelessness, and suicide ideation. The sample consisted of 606 outpatients recruited from several psychiatric settings. It was found that dysthymia was significantly associated with hopelessness. Patients presenting major depressive episode with higher anxiety symptoms had significantly increased scores on the hopelessness scale. Major depressive episode and bipolar disorder, but not dysthymia, were significantly associated with higher levels of suicide ideation. Increased levels of anxiety symptoms in patients with dysthymia were associated with increased levels of suicide ideation, while increased depressive symptoms in patients with specific phobia and generalized anxiety disorder were associated with significantly lower levels of suicide ideation. The findings suggest that depressive disorders, but not anxiety disorders, constitute risk for suicide. Moreover, the differentiation between a depressive and an anxiety disorder as the principal diagnosis, as well as the assessment of anxiety-level symptoms in patients with major depressive episode and dysthymia, seems of special relevance when assessing suicide risk.     

Predicting suicidal risk in a cohort of depressed children and adolescents

Background: In children and adolescents with a depressive disorder, predicting who will also go on to exhibit suicide-related behaviors (SRBs), including suicide attempt or self-harm, is a key challenge facing clinicians. Aims: To investigate the relative contributions of depressive disorder severity, hopelessness, family dysfunction, and perceived social support to the risk of suicide-related behaviors. Methods: This was a cross-sectional study of a group of 10-16-year-olds with major depressive disorders and dysthymic disorder. Results: Child-rated depressive disorder symptom severity emerged as the greatest predictor of risk. Hopelessness and family dysfunction were also significant predictors of SRBs. In combination these variables were strong predictors, accounting for 66% of the variance. This is a cross-sectional study design, rather than longitudinal, therefore risk prediction over time was not possible. Conclusions: Understanding the child and adolescents depressive disorder symptom severity from their perspective, their level of hopelessness, as well as their family context is critical in understanding the risk of SRBs. These findings may help to provide direction for targeted interventions to address these clinical risk factors.