Treatment outcome in suicidal vs. non-suicidal elderly patients

The authors investigated treatment outcome in elderly suicidal and non-suic idal patients with recurrent major depression. Patients without Suicidal id eation in the current episode (Non-Ideators; n = 150) were compared with 30 patients who expressed suicidal ideation (Ideators). Patients received com bined pharmacotherapy and psychotherapy during acute and continuation treat ment Ideators had higher numbers of lifetime suicide attempts and reported significantly, higher levels of depression, anxiety,, and hopelessness befo re starting treatment. Ideators and Non-Ideators had almost identical remis sion rates (77% vs. 78%,), but Ideators had higher relapse rates during con tinuation treatment (26% vs. 13%) and were more likely,, to receive augment ation pharmacotherapy. Anxiety, and use of adjunctive medication, but not s uicidal ideation, were negatively related to both remission and relapse. Ou r data suggest that elderly suicidal patients have an overall favorable tre atment outcome. However treatment response may be more brittle and may requ ire the continuing use of adjunctive medications to prevent early relapse.