@article{ref1,
title="Emergence, persistence, and resolution of suicidal ideation during treatment of depression in old age",
journal="Journal of affective disorders",
year="2007",
author="Szanto, Katalin and Mulsant, Benoit H. and Houck, Patricia R. and Dew, M. A. and Dombrovski, Alexandre Y. and Pollock, Bruce G. and Reynolds, Charles F.",
volume="98",
number="1-2",
pages="153-161",
abstract="INTRODUCTION: To determine the rate and clinical correlates of emergent, persistent, and resolved suicidal ideation during treatment of major depression in the elderly. METHODS: Based on the course of suicidal ideation before and during 12 weeks of antidepressant treatment, we classified 437 elderly patients (234 treated with paroxetine; 203 with nortriptyline) as either non-suicidal or as having &quot;emergent&quot;, &quot;persistent&quot;, or &quot;resolved&quot; suicidality. We compared the four groups on pretreatment demographic and clinical measures and with respect to depression, anxiety, and akathisia during treatment. Results: Rates of emergent, persistent, and resolved suicidality were 7.8%, 12.6%, and 15.6%, respectively. Patients with persistent suicidal ideation were more likely to have recurrent depression than non-suicidal patients or patients whose suicidality resolved with treatment. At the start of treatment, patients in all three suicidal groups had lower self-esteem than non-suicidal patients. During the course of treatment, emergent suicidality was not associated with akathisia, nor did rates of emergent suicidality differ between paroxetine- and nortriptyline-treated patients. While at baseline the levels of depression and anxiety and agitation were similar in the four groups, patients with resolved suicidality had a favorable treatment response, while patients with emergent and persistent suicidality were more likely to maintain higher depression scores and had higher levels of anxiety and agitation during treatment. DISCUSSION: Emergence of suicidal ideation is not common but is clinically significant during treatment of late-life depression and may signal more difficult-to-treat-depression.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2006.07.015",
url="http://dx.doi.org/10.1016/j.jad.2006.07.015"
}