Feelings of worthlessness during a single complicated major depressive episode predict postremission suicide attempt

Jerome C. Wakefield, M. F. Schmitz

Research output: Contribution to journalArticle

Abstract

Objective: To establish which symptoms of major depressive episode (MDE) predict postremission suicide attempts in complicated single-episode cases. Method: Using the nationally representative two-wave National Epidemiologic Survey on Alcohol and Related Conditions data set, we identified wave 1 lifetime single-episode MDE cases in which the episode remitted by the beginning of the wave 2 three-year follow-up period (N = 2791). The analytic sample was further limited to 'complicated' cases (N = 1872) known to have elevated suicide attempt rates, defined as having two or more of the following: suicidal ideation, marked role impairment, feeling worthless, psychomotor retardation, and prolonged (>6 months) duration. Results: Logistic regression analyses showed that, after controlling for wave 1 suicide attempt which significantly predicted postremission suicide attempt (OR = 10.0), the additional complicated symptom 'feelings of worthlessness' during the wave 1 index episode significantly and very substantially predicted postremission suicide attempt (OR = 6.96). Neither wave 1 psychomotor retardation nor wave 1 suicidal ideation nor any of the other wave 1 depressive symptoms were significant predictors of wave 2 suicide attempt. Conclusion: Among depressive symptoms during an MDE, feelings of worthlessness is the only significant indicator of elevated risk of suicide attempt after the episode has remitted, beyond previous suicide attempts.

Original languageEnglish (US)
Pages (from-to)257-265
Number of pages9
JournalActa Psychiatrica Scandinavica
Volume133
Issue number4
DOIs
StatePublished - Apr 1 2016

Keywords

  • Complicated depression
  • Feelings of worthlessness
  • Harmful dysfunction
  • Major depression
  • Major depressive episode
  • Melancholic depression
  • National Epidemiologic Survey on Alcohol and Related Conditions
  • Psychomotor retardation
  • Suicidal ideation
  • Suicide attempt
  • Uncomplicated depression

ASJC Scopus subject areas

  • Psychiatry and Mental health

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