IS THERE A SUICIDALITY SYNDROME INDEPENDENT OF SPECIFIC MAJOR PSYCHIATRIC-DISORDER - RESULTS OF A SPLIT HALF MULTIPLE-REGRESSION ANALYSIS

Biological findings such as low 5-HIAA levels in cerebrospinal fluid ( CSF) in suicidal patients compared to non-suicidal patients independen t of the type of psychiatric disorder indicate a broad basis for suici dality. It is therefore important to ask whether a suicidality syndrom e can be delineated on a phenomenological level, and whether it is ind ependent of specific major psychiatric disorders which are otherwise c onsidered to be aetiologically different. This paper reports on a stud y of 2383 schizophrenic and 1920 depressive unselected patients with a nd without suicidality. They were assessed during the first 24 h after admission to a psychiatric in-patient facility using a comprehensive psychopathological assessment (AMDP system). Using multiple variance a nalysis and logistic regression analysis based on single symptoms, for both suicidal and non-suicidal patients it was shown that a suicidali ty syndrome independent of the underlying illness can be delineated. I n schizophrenia as well as in major affective disorders it was found t hat hopelessness, ruminative thinking, social withdrawal and lack of a ctivity are core symptoms of this suicidal syndrome. The finding of a suicidality syndrome, not associated with a specific major affective d isorder, indicates the need to identify this syndrome, which should be seen as an independent dimension and diagnosed separately, and not re garded merely as a secondary symptom of major psychiatric disorders, p articularly affective disorders.