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LETTER TO EDITOR Table of Contents   
Year : 2006  |  Volume : 48  |  Issue : 4  |  Page : 276
Indicators of suicidal attempt in depression


Central Institute of Psychiatry, Ranchi, India

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How to cite this article:
Chatterjee A, Chakraborty R, Chaudhary S. Indicators of suicidal attempt in depression. Indian J Psychiatry 2006;48:276

How to cite this URL:
Chatterjee A, Chakraborty R, Chaudhary S. Indicators of suicidal attempt in depression. Indian J Psychiatry [serial online] 2006 [cited 2019 Dec 13];48:276. Available from: http://www.indianjpsychiatry.org/text.asp?2006/48/4/276/31572


Sir,

We read with interest the article by Srivastava et al. [1] The authors have tried to identify the possible indicators of suicidal attempt in persons with major depressive disorder. They have examined the sociodemographic and Hamilton Depression Rating Scale (HDRS) variables among depressed persons with and without history of suicidal attempts. Such studies are necessary because cultural variations in the characteristics of persons attempting suicide have been well documented across countries.[2] Since Srivastava et al. [1] examined an outpatient group, we tried to replicate their study in an inpatient sample.

We examined 20 successive persons with a diagnosis of severe depressive episode with suicidal ideation (age= 29.80±9.41 years; 13 males) who were admitted to a psychiatric teaching hospital. None of them were suffering from any neurological, general medical or any other comorbid psychiatric illness including any substance abuse. Treating psychiatric units-blind to the aim of the study-diagnosed these patients and later reconfirmed the diagnosis in post­admission rounds according to the ICD-10 criteria. Before inclusion in the study, we obtained informed consent from all the participants. To measure depressive symptoms in the patients, we applied the HDRS-21-item version.[3] Then we applied the Beck Scale for Suicidal Ideation (SSI)[4] for measuring the intensity of suicidal ideation. Finally, sociodemographic and other clinical information including history of suicidal attempts during the present and past episodes were obtained. The same order of observation was maintained in all the participants to avoid any bias in rating.

A significant number of patients (n=10; 50%) attempted suicide in the present sample. This high frequency of suicide attempts may be due to the inpatient nature of the sample, which is expected to include more severe patients HDRS score: 26.50±4.95). The Mann-Whitney U test and chi-square test revealed no differences in sociodemographic variables such as age, sex, marital status, rural/urban background, socio­occupational status and education. Duration of present episode, number of past episodes, family history of psychiatric illness or suicide were similar. However, there were significantly more past suicidal attempts in persons who attempted suicide in the index episode (p=0.001).

An analysis of HDRS items revealed significantly more paranoid symptoms (p=0.024) in the suicide attempters and a trend towards more somatic anxiety (p=0.074) and hypo­chondriasis (p=0.075) in the non-attempters. There was no difference in the total HDRS score (p=0.268). Interestingly, Srivastava et al. [1] had similar findings.

An analysis of SSI items revealed no difference in the total suicidal ideation score (p=0.414). However, persons who attempted suicide had significantly higher availability of means or opportunity for suicidal attempt (p=0.005). They also showed a trend of more specific planning (p=0.062) and deception/concealment of the contemplated attempt (p=0.081).

Since our study population was small, there is always a chance of error associated with small samples. However, our effort probably indicates the presence of some genuine indi­cators of an imminent suicide attempt in a depressed person. A well-designed study is therefore urgently needed in this area.

 
   References Top

1.Srivastava AS, Kumar R. Suicidal ideation and attempts in patients with major depression: Sociodemographic and clinical variables. Indian J Psychiatry 2005;47:225-8.  Back to cited text no. 1    
2. Kerkhof AJFM, Arensman E. Attempted suicide and deliberate self-harm: Epidemiology and risk factors. In: Gelder MG, Lopez-Ibor Jr JJ, Andreasen NC (eds). New Oxford textbook of psychiatry. New York: Oxford University Press; 2000 (Vol. 1): 1039-45.  Back to cited text no. 2    
3.Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56-62.  Back to cited text no. 3    
4. Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: The scale for suicidal ideation. J Consult Clin Psychol 1979;47:343-52.  Back to cited text no. 4    

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Correspondence Address:
Rudraprosad Chakraborty
Ranchi Institute of Neuro-Psychiatry and Allied Sciences (RINPAS), Kanke, Ranchi 834006, Jharkhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5545.31572

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