Da. Brent et al., MAJOR DEPRESSION OR UNCOMPLICATED BEREAVEMENT - A FOLLOW-UP OF YOUTH EXPOSED TO SUICIDE, Journal of the American Academy of Child and Adolescent Psychiatry, 33(2), 1994, pp. 231-239
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.