@article{ref1,
title="Relating irritability and suicidal ideation using mood and anxiety",
journal="Evidence-based mental health",
year="2019",
author="Malhi, Gin and Bell, Erica and Das, Pritha and Outhred, Tim",
volume="22",
number="3",
pages="95-99",
abstract="BACKGROUND: Suicide is common in the context of depression and bipolar disorders, but there remains a lack of understanding as to how suicide ideation, a common symptom of mood disorders, progresses to suicidal behaviour. Irritability, a feature of some types of depression, is thought to contribute to the development of suicidal behaviour, but these associations are not well established. <br><br>OBJECTIVE: To examine the relationship between irritability and suicide ideation according to the subtype of depression expressed in patients with mood disorder. <br><br>METHODS: 75 patients with mood disorders seen at the CADE (Clinical Assessment Diagnostic Evaluation) Clinic underwent clinical assessment for <i>suicidal ideation</i> (Paykel Suicide Scale), <i>symptom severity</i> (Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HAM-D) (anxious depression), Montgomery-Åsberg Depression Rating Scale (MADRS) (melancholic depression)) and <i>irritability</i> (item 5 of the YMRS). <br><br>FINDINGS: Interestingly, irritability correlated with mania (r=0.734, p<0.001 (YMRS)) and depressive symptom scores (r=0.369, p<0.001 (MADRS); r=0.477, p<0.001 (HAM-D)), which in turn correlated with suicide ideation scores (r=0.364, p<0.01 (MADRS); r=0.275, p=0.017 (HAM-D)). However, despite this indirect association, there was no direct correlation between irritability and suicide ideation (r=0.050, p>0.05). <br><br>CONCLUSIONS: The nature of the relationship between irritability and suicidal ideation is determined by the emotional context within which irritability operates. CLINICAL IMPLICATIONS: Findings suggest that rather than examining irritability alone, consideration of the subtype of depression, especially that of anxious depression, should be paramount in assessing suicide risk.<br><br>© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.<p /> <p>Language: en</p>",
language="en",
issn="1362-0347",
doi="10.1136/ebmental-2019-300100",
url="http://dx.doi.org/10.1136/ebmental-2019-300100"
}