Predictors of suicidality in depressive spectrum disorders in the general population: results of the Netherlands Mental Health Survey and Incidence Study
The aim was to assess determinants of suicidality (suicidal ideation and suicide attempts) in a general population cohort with depressive spectrum disorders, and to compare determinants for suicidal ideation and determinants for suicide attempts in this cohort.
The Netherlands Mental Health Survey and Incidence Study is a epidemiologic survey in the adult population (N = 7,076), using the Composite International Diagnostic Interview (CIDI).
In a cohort of 586 persons with a depressive spectrum disorder, 97 (16.6%) reported suicidal ideation and 19 (3.2%) suicide attempts in a period of 2 years. In a multivariate model, male gender (OR 0.54, 95% CI 0.30–0.99, p = 0.05), longer (>13 months) duration of depression (OR 2.86, 95%CI 1.21–6.73, p = 0.02; OR 2.71, 95% CI 1.24–5.91, p = 0.01), anhedonia (OR 2.00, 95% CI 1.01–5.91, p = 0.05), feeling worthless (OR 1.99, 95% CI 1.05–3.74, p = 0.03), comorbid anxiety (OR 2.46, 95% CI 1.38–4.40, p < 0.01), previous suicidal ideation (OR 3.50, 95% CI 1.96–6.24, p < 0.001) and use of professional care (OR 1.96, 95% CI 1.01–3.79, p = 0.05) were significantly related to suicidality. Determinants of suicidal ideation differed from determinants of suicide attempts.
Suicidality (and not actual suicides) was assessed with only two questions from the CIDI and some determinants for suicidality were assessed in the same time period as suicidality.
Features of depression were the most important determinants of suicidality in a depressive spectrum cohort. Determinants for suicidal ideation differed from suicide attempts. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicidality and eventually suicide.
KeywordsGeneral population Depressive disorders Suicidality Risk factors
- 1.American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental disorders (3rd edn, revised) (DSM-III-R). APA, Washington, DCGoogle Scholar
- 8.Brown GW, Harris TO (1987) Social origins of depression: a study of psychiatric disorder in women. Tavistock, LondonGoogle Scholar
- 17.Graaf R, de Bijl RV, Vollebergh WAM (2000) Response and non-response third wave: the Netherlands Mental Health Survey and Incidence Study (NEMESIS) Technical Report no. 11. Trimbos-institute, UtrechtGoogle Scholar
- 18.Have ten M, Graaf de R, Dorsselaer van S, Verdurmen J, van’t Land H, Vollebergh W, Beekman A (2009) Incidence and course of suicidal ideation and suicide attempts in the general population. Can J Psychiatry (in press)Google Scholar
- 26.Lyketsos CG, Nestadt G, Cwi J (1994) The life chart interview: a standardized method to describe the course of psychopathology. Int J Methods Psychiatr Res 4:143–155Google Scholar
- 27.McCullough JP (2000) Treatment for chronic depression. Cognitive behavorial analysis system of psychotherapy (CBASP). Guilford Press, New YorkGoogle Scholar
- 30.Ormel H (1980) Moeite met leven of een moeilijk leven. Thesis. University GroningenGoogle Scholar
- 33.Smeets RMW, Dingemans PMAJ (1993) Composite International Diagnostic Interview (CIDI), version 1.1. World Health Organization, Amsterdam/GenevaGoogle Scholar
- 34.Smolders M, Laurant M, Akkermans R, Wensing M, Grol R (2008) GP’s assessment of suicide risk in depressed patients. Prim Care Comm Psychiatry 13:138–140Google Scholar
- 37.Suurmeijer TP, Doeglas DM, Briancon S, Krijnen WP, Krol B, Bjelle A et al (1996) The measurement of social support in the ‘European Research on Incapacitating Diseases and Social Support’: the development of the Social Support Questionnaire for Transactions (SSQT). Soc Sci Med 40:1221–1229CrossRefGoogle Scholar
- 39.World Health Organization (1990) Composite Diagnostic Interview (CIDI), version 1.0. World Health Organization, GenevaGoogle Scholar