Suicide in non-major depressions

Abstract

We compared depressive suicides who had unipolar depression not fulfilling the diagnostic criteria of major depression (non-major depressions) with suicides who had major depression. A random sample of 229 suicides representing all suicides in Finland within a 12-month period were comprehensively examined using the psychological autopsy method and diagnosed according to DSM-III-R criteria. We included in this study all cases of current depressive disorder not otherwise specified ( n = 48), adjustment disorder with depressed mood ( n = 6) and dysthymia ( n = 4). These 58 cases of suicide in non-major depressions were compared with the suicides with unipolar major depression ( n = 71) in the same random sample. The non-major depressive victims were younger, and comprised more males, more cases with psychoactive substance use disorders, more secondary depressives, and more cases not having contact with health care, or cases not having communicated suicidal intent despite such contact. Recent life events were also reported more common among those with non-major depressions, particularly during the final week. The findings suggest that suicides in major depression and in unipolar depressions not fulfilling the criteria for major depression are likely to differ in several clinically relevant characteristics besides depressive symptomatology.