MAJOR DEPRESSION OR UNCOMPLICATED BEREAVEMENT - A FOLLOW-UP OF YOUTH EXPOSED TO SUICIDE

Objective: To determine whether the depressive reactions experienced b y youth exposed to suicide were uncomplicated bereavement or major dep ression by examining the longitudinal risk of recurrent major depressi on. Method: The 121 friends and acquaintances of 26 adolescent suicide victims were followed up 1 to 18 months after an initial interview th at took place around 6 months after the death of the suicide victim. A demographically similar group of 138 unexposed controls was also foll owed up. Results: The median duration of depression in the 37 subjects who became depressed after exposure was 8 months. The exposed group, compared with controls, had a higher rate of incident depression (RR = 1.7, 95% CI = 1.0-2.8) during the follow-up period, even after adjust ment for previous history of depression and other risk factors for dep ression. Within the group of exposed subjects, the rate of depression on follow-up was highest in those who developed a depressive disorder before exposure to suicide, intermediate in those who developed depres sion after exposure, and lowest in those who were not depressed at the first interview after exposure. There was no evidence of an increased incidence of suicide attempts in the exposed group relative to the un exposed controls on follow-up. Conclusions: The depressive reactions o bserved in youth exposed to suicide are most consistent with major dep ressive episodes on the basis of course and risk of recurrence. Exposu re to suicide was associated with an increased risk of recurrent depre ssion but not with an increased long-term risk of suicidal behavior.