Citation

Gournellis R, Tournikioti K, Touloumi G, Thomadakis C, Michalopoulou PG, Christodoulou C, Papadopoulou A, Douzenis A. Acta Psychiatr. Scand. 2018; 137(1): 18-29.

Affiliation

Second Department of Psychiatry, Medical School, University General Hospital 'ATTIKON', National and Kapodistrian University of Athens, Athens, Greece.

Copyright

(Copyright © 2018, John Wiley and Sons)

DOI

10.1111/acps.12826

PMID

29178463

Abstract

OBJECTIVE: It still remains unclear whether psychotic features increase the risk of suicidal attempts in major depressive disorder. Thus, we attempted, through a systematic review coupled with a meta-analysis, to elucidate further whether unipolar psychotic depression (PMD) compared to non-PMD presents higher levels of suicidal attempts.

METHOD: A systematic search was conducted in PubMed, EMBASE, PsycINFO as well as in various databases of the so-called gray literature for all studies providing data on suicidal attempts in PMD compared to non-PMD, and the results were then subjected to meta-analysis.

RESULTS: Twenty studies met our inclusion criteria, including in total 1,275 PMD patients and 5,761 non-PMD patients. An elevated risk for suicide attempt for PMD compared to non-PMD patients was found: The total (lifetime) fixed-effects pooled OR was 2.11 (95% CI: 1.81-2.47), and the fixed-effects pooled OR of the five studies of the acute phase of the disorder was 1.93 (95% CI: 1.33-2.80). This elevated risk of suicidal attempt for PMD patients remained stable across all age groups of adult patients.

CONCLUSION: Despite data inconsistency and clinical heterogeneity, this systematic review and meta-analysis showed that patients with PMD are at a two-fold higher risk, both during lifetime and in acute phase, of committing a suicidal attempt than patients with non-PMD.

© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Language: en

Keywords

age; clinical features; meta-analysis; psychotic depression; suicidal attempt; systematic review