Abstract
BackgroundThe current analysis utilized data collected via an online patient community platform, PatientsLikeMe (PLM) to compare patient-reported experiences in patients with major depressive disorder (MDD) with suicidal ideation (MDSI) to those with MDD but without suicidal ideation.MethodsPLM members who joined PLM between May-2007 and February-2018 and reported a diagnosis of MDD were included. The MDSI cohort included patients with MDD who reported at least one suicide-related symptom at a severity greater than “none”. Demographics, comorbidities, symptoms, and side-effects were compared between MDSI and MDD cohorts. Factors correlated with suicidal ideation (SI) were determined by a random forest procedure.ResultsPatients in the MDSI cohort (n = 266) were younger (median age, 36 vs 44 years) with an earlier disease onset (before 30 years, 83% vs 71%), and a longer diagnosis latency (median, 4 vs 2 years) vs patients in the MDD cohort (n = 11,963). Majority of patients were women in both cohorts (73% vs 83%). Median number of psychiatric comorbidities was higher in the MDSI cohort (4 vs 3). Unprompted symptoms (e.g., loneliness, feeling of hopelessness, social anxiety, impulsivity, and self-hating thoughts) were more frequent in the MDSI cohort. Hopelessness, loneliness, anhedonia, social anxiety, and younger age were highly correlated with suicidal ideation.ConclusionsThis analysis utilized patient-reported data to better understand symptoms, experiences, and characteristics of patients with MDSI compared to patients with MDD. The results identified various risk factors correlated with suicidal ideation that may help guide clinical judgement for patients with MDD who may not voluntarily report suicidal ideation.
Highlights
The current analysis utilized data collected via an online patient community platform, PatientsLikeMe (PLM) to compare patient-reported experiences in patients with major depressive disorder (MDD) with suicidal ideation (MDSI) to those with MDD but without suicidal ideation
Patients in the PLM community were not prompted to report any symptom related to suicide ideation (SI), those patients who reported at least one SI-related symptom (“suicidal thoughts or urges,” “suicidal,” “depression with suicidal thoughts,” “SI,” “suicide attempt,” or “suicidal behavior”) at a severity greater than none were included in the Major depressive disorder with suicidal ideation (MDSI) cohort
Patient characteristics Of the 12,229 PLM users with MDD who registered and provided data during the study period, 266 reported symptoms related to suicidality with a severity greater than none (MDSI cohort), and 11,963 reported never experiencing any of these symptoms (MDD cohort)
Summary
The current analysis utilized data collected via an online patient community platform, PatientsLikeMe (PLM) to compare patient-reported experiences in patients with major depressive disorder (MDD) with suicidal ideation (MDSI) to those with MDD but without suicidal ideation. Suicide is a major public health concern and is one of the leading causes of death worldwide [1]. In the U.S, 47,000 deaths were reported in 2017 due to suicide. Of the 17.6 million patients with major depressive disorder (MDD), 5.5 million adults reported suicide ideation (SI) and 2 million patients reported SI with intent [2]. The highest prevalence of suicide is found in the most economically productive age group (15–44 years) [5]. Examination of data of young adults aged 18–25 years from the National Surveys on Drug Use and Health (2009– 2015) showed an increase in the 12-month prevalence of SI (6.1 to 8.3%), suicide plan (2.0 to 2.7%), and suicide attempt (1.1 to 1.6%) [6]
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