A longitudinal population-based study exploring treatment utilization and suicidal ideation and behavior in major depressive disorder

作者：Chartrand Hayley; Robinson Jennifer; Bolton James M^*

来源：Journal of Affective Disorders, 2012, 141(2-3): 237-245.

DOI：10.1016/j.jad.2012.03.040

• Major depressive disorder
• Suicide attempts
• Suicidal ideation
• Treatment use
• Epidemiology

Background: This study aimed to longitudinally examine the relationship between treatment utilization and suicidal behavior among people with major depressive disorder in a nationally representative sample. %26lt;br%26gt;Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (Wave 1: N=43,093; Wave 2: N=34,653). Suicidal and non-suicidal individuals at Wave 1 were compared based on subsequent treatment utilization. Suicidal behavior at Wave 2 was compared between people with major depressive disorder who had sought treatment at Wave 1 versus those that had not. %26lt;br%26gt;Results: Individuals with past year major depressive disorder at Wave 1 who attempted suicide were more likely to be hospitalized at follow up compared to non-suicidal people with major depressive disorder [adjusted odds ratio (AOR)=4.46; 95% confidence interval [95% CI]: 2.54-7.85]; however, they were not more likely to seek other forms of treatment. Among those with past year major depressive disorder who sought treatment at baseline, visiting an emergency room (AOR=3.08; 95% CI: 1.61-5.89) and being hospitalized (AOR=2.41; 95% CI: 1.13-5.14), was associated with an increased likelihood of attempting suicide within 3 years even after adjusting for mental disorder comorbidity, depression severity, and previous suicidal behavior. %26lt;br%26gt;Limitations: Unable to draw conclusions about completed suicide or adequacy of treatment. %26lt;br%26gt;Conclusions: Suicidal behavior does not lead individuals with major depressive disorder to seek treatment with professionals or use antidepressant medications; instead, they are more likely to use emergency services. These findings suggest that treatment efforts for people with major depressive disorder who are suicidal need improvement.

• 出版日期2012-12-10