RELATIONSHIP BETWEEN RECOGNIZED DEPRESSION AND SUICIDE IN HUNGARY

In the 1980s, the suicide rate in Hungary was the highest in Europe. A retrospective analysis of 200 consecutive suicides revealed depressiv e illness in 63%, with primary major depression in 50%, and schizophre nia in 8%. The primary major depression group was divided equally betw een unipolar disorders and bipolar II disorder, compared to an inciden ce of bipolar disorder of less than 1% in the general population. Conc omitant depression with panic disorders was associated with a higher r isk of suicide than panic disorder alone. Only 16% of suicides had see n their general practitioner; the suicide rate was lower in regions wi th more practising general practitioners and a higher rate of reported depression. Drug treatment prior to suicide with anxiolytics or hypno tics (33%) was more common than treatment with lithium (2%) or antidep ressants (18%). In a further study, lithium treatment markedly reduced the number of suicide attempts by patients with bipolar disorder. In conclusion, suicide in Hungary was associated strongly with psychiatri c illness, particularly primary major depression. Poor access to healt hcare due to a lack of practising general practitioners, appears to ha ve exacerbated the suicide risk. The development of suicide prevention strategies, which enhance the effectiveness of healthcare services, h as reduced the suicide rate substantially over the last decade.