Symptom components of standard depression scales and past suicidal behavior☆
Received 15 November 2004; accepted 11 March 2005.
Abstract
Background
Global severity on depression scales may obscure associations between specific symptoms and suicidal behavior.
Methods
We studied 298 persons with major depressive disorder. Factor analysis of the 24-item Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI) was used to compare symptom clusters between past suicide attempters and non-attempters.
Results
Factor analyses extracted five HDRS and three BDI factors. Suicide attempters had significantly lower scores on an HDRS anxiety factor and higher scores on a BDI self-blame factor. The factor scores correlated with total number of suicide attempts and with known risk factors for suicidal behavior.
Limitations
The differences in factor scores between suicide attempters and non-attempters were significant but modest and may be most relevant in suggesting areas for further clinical studies. Structured diagnostic interviews in this study may have limited the detection of Bipolar II or milder bipolar spectrum disorders.
Conclusions
Depressed suicide attempters exhibit comparably severe mood and neuro-vegetative symptoms, but less anxiety and more intense self-blame than non-attempters. This clinical profile may help guide studies of biological correlates and of treatments to reduce suicide risk.
Department of Neuroscience, New York State Psychiatric Institute and Columbia University, United States
Corresponding author. Department of Neuroscience, New York State Psychiatric Institute, 1051 Riverside Drive, Box 42, New York, NY 10032, United States. Tel.: +1 212 543 5842; fax: +1 212 543 6017.
☆ Supported by PHS grants MH62185 (Conte Center for the Neuroscience of Mental Disorders: The Neurobiology of Suicidal Behavior) and MH48514 (Psychobiological Predictors of Suicidal Behavior in MDE).
ABSTRACT