Skip to main content
main-content

01.12.2018 | Review | Ausgabe 1/2018 Open Access

Annals of General Psychiatry 1/2018

Psychotic (delusional) depression and completed suicide: a systematic review and meta-analysis

Zeitschrift:
Annals of General Psychiatry > Ausgabe 1/2018
Autoren:
Rossetos Gournellis, Kalliopi Tournikioti, Giota Touloumi, Christos Thomadakis, Panayiota G. Michalopoulou, Ioannis Michopoulos, Christos Christodoulou, Athanasia Papadopoulou, Athanasios Douzenis
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12991-018-0207-1) contains supplementary material, which is available to authorized users.

Abstract

Background

It remains unclear whether psychotic features increase the risk of completed suicides in unipolar depression. The present systematic review coupled with a meta-analysis attempts to elucidate whether unipolar psychotic major depression (PMD) compared to non-PMD presents higher rates of suicides.

Methods

A systematic search was conducted in Scopus, PubMed, and “gray literature” for all studies providing data on completed suicides in PMD compared to non-PMD, and the findings were then subjected to meta-analysis. All articles were independently extracted by two authors using predefined data fields.

Results

Nine studies with 33,873 patients, among them 828 suicides, met our inclusion criteria. PMD compared to non-PMD presented a higher lifetime risk of completed suicides with fixed-effect pooled OR 1.21 (95% CI 1.04–1.40). In a sub-analysis excluding a very large study (weight = 86.62%), and comparing 681 PMD to 2106 non-PMD patients, an even higher pooled OR was found [fixed-effect OR 1.69 (95% CI 1.16–2.45)]. Our meta-analysis may provide evidence that the presence of psychosis increases the risk of suicide in patients suffering from severe depression. The data are inconclusive on the contribution of age, mood congruence, comorbidity, and suicide method on PMD’s suicide risk. The lack of accurate diagnosis at the time of suicide, PMD’s diagnostic instability, and the use of ICD-10 criteria constitute the main study limitations.

Conclusions

The presence of psychosis in major depression should alert clinicians for the increased risk of completed suicide. Thus, the implementation of an effective treatment both for psychotic depression and patients’ suicidality constitutes a supreme priority.
Zusatzmaterial
Additional file 1. Additional figures.
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2018

Annals of General Psychiatry 1/2018 Zur Ausgabe

Neu im Fachgebiet Psychiatrie

Meistgelesene Bücher aus dem Fachgebiet

2017 | Buch

Pocket Guide Psychopharmaka von A bis Z

Im Pocket Guide finden Sie von A bis Z schnell und übersichtlich die "Erste-Hilfe"-Information rund um alle Psychopharmaka, die Sie auf Station und im Praxisalltag brauchen. Das Pocket-Buch passt bestens in die Kitteltasche. Auf eine ausführliche Darstellung der Störungen wurde bewusst verzichtet.

Autoren:
Prof. Dr. med. Otto Benkert, Prof. Dr. med. I.-G. Anghelescu, Prof. Dr. med. G. Gründer, Prof. Dr. med. P. Heiser, Prof. Dr. rer. Nat. C. Hiemke, Prof. Dr. med. H. Himmerich, Prof. Dr. med. F. Kiefer, Prof. Dr. med. C. Lange-Asschenfeldt, Prof. Dr. med., Dr. rer. nat., Dipl.-Psych. M.J. Müller, Dr. med., Dipl.-Kfm. M. Paulzen, Dr. med. F. Regen, Prof. Dr. med. A. Steiger, Prof. Dr. med. F. Weber

2016 | Buch

Klinikmanual Psychiatrie, Psychosomatik und Psychotherapie

Dieses Kitteltaschenbuch enthält übersichtlich und systematisch alle notwendigen Informationen zum schnellen Nachschlagen auf Station, in der Ambulanz oder im Konsildienst: Klare Handlungsanweisungen, Therapieempfehlungen und die notwendigen rechtlichen Hintergründe.

Herausgeber:
Prof. Dr. Dr. Frank Schneider