Abstract
Objective: To analyze the factors associated with recent suicide attempts including socio-demographic and clinical characteristics in major depressive disorder (MDD) patients in China.Methods: The data were from a nationwide sample from 13 major psychiatric hospitals or the psychiatric units of general hospitals in China, from September 1, 2010 to February 28, 2011. Melancholic features and suicide attempts in the past month were defined according to the melancholic feature module and the suicide module of the Mini International Neuropsychiatric Interview (MINI). Socio-demographic and clinical characteristics were compared between MDD patients with and without recent suicide attempts. Further analyses regarding the factors associated with recent suicide attempts in MDD patients were performed via multivariate logistic regression analysis.Results: Among 1,172 MDD patients, 57 (4.9%) were reported to have made a suicide attempt in the past month. Compared to the MDD patients without recent suicide attempt, significantly higher percentage of patients in the recent suicide attempters group had previous suicide attempts (χ2 = 171.861, p < 0.001) and depressive episodes with melancholic features (χ2 = 22.837, p < 0.001). Logistic regression analysis indicated that previous suicide attempts (OR = 20.81, 95% CI: 11.12–38.94, p < 0.001) and depressive episodes with melancholic features (OR = 4.43, 95% CI: 2.09–9.43, p < 0.001) were independently associated with recent suicide attempts in MDD patients.Limitations: Cross-sectional design, retrospective recall of suicide attempt data.Conclusion: Recent suicide attempts are associated with melancholic features and previous suicide attempts in MDD patients in China. These data may help clinicians to identify MDD patients at high risk of suicide attempt behavior.
Highlights
Suicide is a serious public health problem that has received increasing attention worldwide [1, 2]
A national case-control psychological autopsy study conducted in China showed that mental disorders are present in up to 63% of people who died by suicide [4]
1,172 patients were included in the present study, and 57 (4.9%) of the subjects had a suicide attempt during the past month
Summary
Suicide is a serious public health problem that has received increasing attention worldwide [1, 2]. According to a WHO report, an estimated 7,88,000 people died from suicide in the year 2015 globally, and the age-standardized suicide rate was 10.7 per 1,00,000 persons [3]. In China, the suicide rate was 8.5 per 1,00,000 persons [3]. A national case-control psychological autopsy study conducted in China showed that mental disorders are present in up to 63% of people who died by suicide [4]. The most common mental illness among the individuals who died by suicide was major depressive disorder (MDD) [4]. A Swedish epidemiological study showed that depression is associated with a 20-fold increased risk of suicide [5]. A previous suicide attempt is the strongest risk factor for subsequent suicide attempt and death [7,8,9]. Identifying the factors associated with suicide attempts is important for early identification efforts and can lead to reduction in the incidence of suicide
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