Citation

Pompili M, Baldessarini RJ, Tondo L, Innamorati M, Tatarelli R, Girardi P, De Pisa E. J. Affect. Disord. 2010; 122(1-2): 154-158.

Affiliation

Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy. maurizio.pompili@uniroma1.it

Copyright

(Copyright © 2010, Elsevier Publishing)

DOI

10.1016/j.jad.2009.07.018

PMID

19709752

Abstract

BACKGROUND: As effects of suicidal status on antidepressant responses remain uncertain, we compared responses to treatment in suicidal and nonsuicidal depressed patients. METHODS: We evaluated treatment response and covariates in 82 depressed patients diagnosed with DSM-IV major depressive (n=50) or bipolar disorders (n=32) treated initially in a day-hospital for 2 weeks, followed by 4 weeks of outpatient treatment, using citalopram given intravenously and then orally, with or without a mood-stabilizer. Suicidal status was based on an intake score of > or = 3 on item-3 of the 17-item Hamilton Depression Rating Scale, verified by clinical assessment. Morbidity and clinical change were assessed with the remaining 16 items (HDRS(16)). RESULTS: Suicidal (n=31) and nonsuicidal subjects (n=51) were similar in baseline ratings of depressive symptom-severity but were depressed longer and more likely to abuse substances. Suicidal ratings improved by 36% during 6 weeks of treatment among initially suicidal patients, but other depressive symptoms (HDRS(16)) improved half as much as in nonsuicidal subjects (13.4 vs. 25.1 points), independent of diagnosis, initial illness-severity, and treatment, and half as many patients improved by > or = 20%. In multivariate modeling, only being suicidal predicted poor response. CONCLUSIONS: Being suicidal may limit response to treatment in depressed major affective disorder patients, independent of diagnosis or overall symptomatic severity.

Language: en