Persistence and resolution of suicidal ideation during treatment of depression in patients with significant suicidality at the beginning of treatment: The CRESCEND study

Ho Jun Seo, Young Eun Jung, Seunghee Jeong, Jung Bum Kim, Min-Soo Lee, Jae Min Kim, Hyeon Woo Yim, Tae Youn Jun

    Research output: Contribution to journalArticlepeer-review

    12 Citations (Scopus)

    Abstract

    Background The appropriate length of time for patients who visit clinics with significant suicidal ideation to be closely monitored is a critical issue for clinicians. We evaluated the course of suicidal ideation and associated factors for persistent suicidality in patients who entered treatment for depression with significant suicidal ideation. Methods A total of 565 patients who had both moderate to severe depression (Hamilton Depression Rating Scale (HAMD) score ≥14) and significant suicidal ideation (Beck Scale for Suicide Ideation (SSI-B) score ≥6) were recruited from 18 hospitals in South Korea. Participants were assessed using the SSI-B, HAMD, Hamilton Anxiety Rating Scale, and Clinical Global Impression Scale-severity during a 12-week naturalistic treatment with antidepressant intervention. Participants were classified into resolved suicidality or persistent suicidality groups according to whether their suicidal ideation improved to SSI-B scores <6 and were sustained for 12 weeks. Results During the 12-week treatment, 206 (36.4%) patients were classified in the resolved suicidality group. Persistent suicidality was associated with intervention with SSRIs, higher SSI-B baseline score, and no HAMD or HAMA remission. The proportions of participants who had persistent suicidal ideation even with HAMD remission or response were 0.25 and 0.34, respectively. Limitations This study was observational, and the treatment modality was naturalistic. Conclusions A considerable number of patients had persistent suicidal ideation despite 12 weeks of antidepressant treatment. Close monitoring for suicidal ideation may be needed beyond the initial weeks of treatment and even after a response to antidepressants is observed.

    Original languageEnglish
    Pages (from-to)208-215
    Number of pages8
    JournalJournal of Affective Disorders
    Volume155
    Issue number1
    DOIs
    Publication statusPublished - 2014 Feb 1

    Keywords

    • Depression
    • Persistent suicidality
    • Predictive factor
    • Resolved suicidality
    • Suicide ideation

    ASJC Scopus subject areas

    • Clinical Psychology
    • Psychiatry and Mental health

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