Psychopathological predictors of suicide in patients with major depressionduring a 5-year follow-up

Objective. It is widely known that the risk of suicide is higher in cases o f major depressive disorders in comparison to the general population. The p urpose of this study was to examine which psychopathologic symptoms during the index episode are predictors for an increased risk of suicide in the fu rther course of major depression. Method, Mortality data were determined fr om a prospective study of 280 patients with major depression (DSM-III-R, si ngle episode or recurrent) during a follow-up period of 5 years. The predic tive power of different depressive symptoms including psychotic symptoms fo r suicide risk was investigated. Results. Patients who committed suicide (N = 16) during the follow-up period had reported significantly more often hy pochondriacal preoccupations or delusions (but not delusions or preoccupati ons of impoverishment, guilt or sin), suicidal thoughts and suicide attempt s as well as feelings of severe hopelessness during the index episode than still living patients or patents who had died from natural causes. Conclusi on. These symptoms seem to be helpful early predictors for the risk of suic ide during the further course of illness. This should be taken into account for suicide prevention in the course of major depression. (C) 2001 Edition s scientifiques et medicales Elsevier SAS.