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Suicide, Attempted Suicide, and Relapse Rates in Depression: Occurrence After ECT and Antidepressant Therapy

Suicide, Attempted Suicide, and Relapse Rates in Depression: Occurrence After ECT and... Abstract • Suicide, attempted suicide, and relapse rates in 519 depressives were examined, comparing the effects of different treatments. After six months, suicide attempts were seen significantly less frequently in the ECT groups (0.8%) than in the antidepressant group (4.2%) or the "adequate" antidepressant subgroup (7.0%) Fewer suicide attempts occurred in the ECT group compared to the antidepressant group among both in those who had attempted suicide prior to admission (0% vs 10%) and in those who had not (1.1% vs 3.6%). A history of attempted suicide showed a greater risk of both suicide (2.9%) in the following year and subsequent suicide attempt (5.9%). A depressive diagnosis may be as good a predictor of suicidal behavior as a history of attempted suicide. Relapse rates did not differ between treatment groups. References 1. Robins E, Murphy GE, Wilkinson RH, et al: Some clinical considerations in the prevention of suicide based on a study of 134 successful suicides . Am J Public Health 49:888-899, 1959.Crossref 2. Murphy GE: The physician's responsibility for suicide: II. Errors of omission . Ann Intern Med 83:305-309, 1975.Crossref 3. Barraclough B, Bunch J, Nelson B, et al: A hundred cases of suicide: Clinical aspects . Br J Psychiatry 125:355-373, 1974.Crossref 4. Seager CP, Flood RA: Suicide in Bristol . Br J Psychiatry 111:919-932, 1965.Crossref 5. Burvill PW: Suicide in Western Australia, 1967: An analysis of coroners' records . Aust NZ J Psychiatry 5:37-44, 1971.Crossref 6. Langeluddeke A: Uber lebenswartung und ruchfallshaufigheit bei manis-depressiven . Z Psychol Hyg 14:1-16, 1941. 7. Slater E: Zur erbpathologia des manisch-depressiven irreseins: Die eltern und kindern von manisch-depressiven . Z Neurol Psychiatr 163:1-47, 1938.Crossref 8. Lundquist G: Prognosis and course in manic-depressive psychosis: A follow-up study of 319 first admissions . Acta Psychiatr Neurol 35( (Suppl) ):1-96, 1945. 9. Schulz B: Sterblickkeit endogen geisteskranker unde ihrer eltern . Z Menschl Vererb Konstitutionsl 29:338-367, 1949. 10. Stenstedt A: A study in manic-depressive psychosis, clinical, social, and genetic investigations . Acta Psychiatr Scand , (suppl 79) , 1952, pp 1-11. 11. Avery DH, Winokur G: Mortality in depressed patients treated with electroconvulsive therapy and antidepressants . Arch Gen Psychiatry 33:1029-1037, 1976.Crossref 12. Avery DH, Winokur G: The efficacy of electroconvulsive therapy and antidepressants in depression . Biol Psychiatry 12:507-523, 1977. 13. Pokorny AD: Suicide rates in various psychiatric disorders . J Nerv Ment Dis 139:499-506, 1964.Crossref 14. Ziskind E, Somerfeld-Ziskind E, Ziskind L: Metrazol and electroconvulsive therapy of the affective psychoses . Arch Neurol Psychiatry 53:212-217, 1945.Crossref 15. Huston PE, Locher LM: Involutional psychosis: Course when untreated and when treated with electric shock . Arch Neurol Psychiatry 59:385-394, 1948.Crossref 16. Huston PE, Locher LM: Manic-depressive psychosis: Course when treated and untreated with electric shock . Arch Neurol Psychiatry 60:37-48, 1948.Crossref 17. DeCarolis V, Giberti F, Roccatagliata G, et al: Imipramine and electroshock in the treatment of depression: A clinical statistical analysis of 437 cases . Sist Nerv 16:29-42, 1964. 18. Greenblatt M, Grosser GH, Wechsler H: Differential response of hospitalized depressed patients to somatic therapy . Am J Psychiatry 120:935-943, 1964. 19. Hordern A, Burt CG, Holt NF: Depressive States . Springfield, Ill, Charles C Thomas Publisher, 1965. 20. Bratfos 0, Haug JO: Electroconvulsive therapy and antidepressant drugs in manic-depressive disease, treatment results at discharge and three months later . Acta Psychiatr Scand 41:588-596, 1965.Crossref 21. Clinical trial of the treatment of depressive illness, Medical Research Council . Br Med J 1:881-886, 1965.Crossref 22. Angst J, Varga E, Shepherd M: Preliminary report of a retrospective study of the treatments of depression. Excerpta Medica International Congress Series No. 129, 1967. Proceedings of the Fifth International Congress of the Collegium Internationale Neuropsychopharmacologium, Washington, 28-31, March 1966. 23. Hutchinson JT, Smedberg D: Treatment of depression: A comparative study of ECT and six drugs . Br J Psychiatry 109:536-538, 1963.Crossref 24. Lönnqvist J, Niskanen P, Rinta-Mänty R, et al: Suicides in psychiatric hospitals in different therapeutic eras: A review of literature and own study . Psychiatr Fenn pp 265-273, 1974. 25. Hessø R, Retterstøl NT: Nor Laegeforen 95:1571, 1975. 26. Krieger G: Suicides, drugs and the open hospital . Hosp Commun Psychiatry , (July) 1966, pp 196-199. 27. Hussar AE: Effect of tranquilizers on medical morbidity and mortality in a mental hospital . JAMA 179:682-686, 1962.Crossref 28. Beisser AR, Blanchette J: A study of suicides in a mental hospital . Dis Nerv Syst 22:365-369, 1961. 29. Barraclough BM, Pallis DJ: Depression followed by suicide: A comparison of depressed suicides with living depressives . Psychol Med 5:55-61, 1975.Crossref 30. Simpson GM, Lee HL, Cuculic Z, et al: Two doses of imipramine in hospitalized endogenous and neurotic depressions . Arch Gen Psychiatry 33:1093-1102, 1976.Crossref 31. Burrows GD, Maguire KP, Scoggins BA, et al: Plasma nortriptyline and clinical response— study using changing plasma levels . Psychol Med 7:87-91, 1977.Crossref 32. Ziegler VE, Clayton PJ, Biggs JT: A comparison study of amitriptyline and nortriptyline with plasma levels . Arch Gen Psychiatry 34:607-612, 1977.Crossref 33. Segal BE, Humphrey J: A comparison of suicide victims and suicide attempters in New Hampshire . Dis Nerv Syst 31:830-838, 1970. 34. Schmidt E, O'Neal P, Robins E: Evaluation of suicide attempts as a guide to therapy . JAMA 155:549-557, 1954.Crossref 35. Motto JA: Suicide attempts, a longitudinal view . Arch Gen Psychiatry 13:516-520, 1965.Crossref 36. Batchelor IRC, Napier MD: The sequelae and short-term prognosis of attempted suicide: The results of a one-year follow-up of 200 cases . J Neurol Neurosurg Psychiatry 17:261-266, 1954.Crossref 37. Jansson B: A catamnestic study of 476 attempted suicide with special regard to the prognosis for cases of drug automatism . Acta Psychiatr Scand 38:183-198, 1962.Crossref 38. Guze SB, Robins E: Suicide and primary affective disorders . Br J Psychiatry 117:437-438, 1970.Crossref 39. Kessel N, McCullock W, Simpson E: Psychiatric service in a centre for the treatment of poisoning . Br Med J 2:985-988, 1963.Crossref 40. Rosen DH: The serious suicide attempt: Epidemiological and followup study of the patients . Am J Psychiatry 127:764-770, 1970. 41. Bratfos O: Attempted suicide . Acta Psychiatr Scand 47:38-56, 1971.Crossref 42. Murphy GE: Clinical identification of suicidal risk . Arch Gen Psychiatry 27:356-359, 1972.Crossref 43. Kennedy P, Kreitman N, Ovenstone MK: The prevalence of suicide and parasuicide ("attempted suicide") in Edinburgh . Br J Psychiatry 124:36-41, 1974.Crossref 44. Kraft DP, Babigian HM: Suicide by persons with and without psychiatric contacts . Arch Gen Psychiatry 33:209-215, 1976.Crossref 45. Dorpat TL, Ripley HS: A study of suicide in the Seattle area . Compr Psychiatry 1:349-359, 1960.Crossref 46. Robins E, Gassner S, Kayes J, et al: The communication of suicidal intent: A study of 134 consecutive cases of successful (completed) suicide . Am J Psychiatry 115:724-733, 1959. 47. Rosen A: Detection of suicidal patients: An example of some limitations in the prediction of infrequent events . J Consult Clin Psychol 18:397-403, 1954.Crossref 48. Juel-Nielsen N, Bille M, Flygenring J, et al: Frequency of depressive states within geographically delimited population groups-incidence (the Aarhus County investigation) . Acta Psychiatr Scand 37( (suppl 162) ):69-80, 1961.Crossref 49. Pederson AM, Barry DJ, Babigian HM: Epidemilogical considerations of psychotic depression . Arch Gen Psychiatry 27:193-197, 1972.Crossref 50. Silverman D: The epidemiology of depression-a review . Am J Psychiatry 124:883-891, 1968. 51. Weissman MM: The epidemiology of suicide attempts, 1960 to 1971 . Arch Gen Psychiatry 30:737-746, 1974.Crossref 52. Salzman L: An evaluation of shock therapy . Am J Psychiatry 103:669-679, 1947. 53. Oltman JE, Friedman S: Analysis of temporal factors in manicdepressive psychosis, with particular reference to the effect of shock therapy . Am J Psychiatry 107:57-68, 1950. 54. Bratfos O, Haug JO: The course of manic-depressive psychosis . Acta Psychiatr Scand 44:89-112, 1968.Crossref 55. Angst J, Baastrup P, Grof P, et al: The course of monopolar depression and bipolar psychoses . Psychiatr Neurol Neurochir 76:489-500, 1973. 56. DeCarolis V, Gibert F, Roccatagliata G, et al: Rilievi catamnestici della terapia imipraminica ed eletroconvulsivante delle depressioni . Sist Nerv 1:43-52, 1964. 57. Seager CP, Bird RL: Imipramine with electrical treatment in depression-a controlled trial . J Ment Sci 108:704-707, 1962. 58. Kay DWK, Fahy T, Garside RF: A seven-month double-blind trial of amitriptyline and diazepam in ECT-treated depressed patients . Br J Psychiatry 117:667-671, 1970.Crossref 59. Mindham RHS, Howland C, Shepherd M: An evaluation of continuation therapy with tricyclic antidepressants in depressive illness . Psychol Med 3:5-17, 1973.Crossref 60. Klerman GL, DiMascio A, Weissman M, et al: Treatment of depression by drugs and psychotherapy . Am J Psychiatry 131:186-191, 1974. 61. Paykel E, DiMascio A, Haskell D, et al: Effects of maintenance amitriptyline and psychotherapy on symptoms of depression . Psychol Med 5:67-77, 1975.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Suicide, Attempted Suicide, and Relapse Rates in Depression: Occurrence After ECT and Antidepressant Therapy

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References (61)

Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1978.01770300091010
Publisher site
See Article on Publisher Site

Abstract

Abstract • Suicide, attempted suicide, and relapse rates in 519 depressives were examined, comparing the effects of different treatments. After six months, suicide attempts were seen significantly less frequently in the ECT groups (0.8%) than in the antidepressant group (4.2%) or the "adequate" antidepressant subgroup (7.0%) Fewer suicide attempts occurred in the ECT group compared to the antidepressant group among both in those who had attempted suicide prior to admission (0% vs 10%) and in those who had not (1.1% vs 3.6%). A history of attempted suicide showed a greater risk of both suicide (2.9%) in the following year and subsequent suicide attempt (5.9%). A depressive diagnosis may be as good a predictor of suicidal behavior as a history of attempted suicide. Relapse rates did not differ between treatment groups. References 1. Robins E, Murphy GE, Wilkinson RH, et al: Some clinical considerations in the prevention of suicide based on a study of 134 successful suicides . Am J Public Health 49:888-899, 1959.Crossref 2. Murphy GE: The physician's responsibility for suicide: II. Errors of omission . Ann Intern Med 83:305-309, 1975.Crossref 3. Barraclough B, Bunch J, Nelson B, et al: A hundred cases of suicide: Clinical aspects . Br J Psychiatry 125:355-373, 1974.Crossref 4. Seager CP, Flood RA: Suicide in Bristol . Br J Psychiatry 111:919-932, 1965.Crossref 5. Burvill PW: Suicide in Western Australia, 1967: An analysis of coroners' records . Aust NZ J Psychiatry 5:37-44, 1971.Crossref 6. Langeluddeke A: Uber lebenswartung und ruchfallshaufigheit bei manis-depressiven . Z Psychol Hyg 14:1-16, 1941. 7. Slater E: Zur erbpathologia des manisch-depressiven irreseins: Die eltern und kindern von manisch-depressiven . Z Neurol Psychiatr 163:1-47, 1938.Crossref 8. Lundquist G: Prognosis and course in manic-depressive psychosis: A follow-up study of 319 first admissions . Acta Psychiatr Neurol 35( (Suppl) ):1-96, 1945. 9. Schulz B: Sterblickkeit endogen geisteskranker unde ihrer eltern . Z Menschl Vererb Konstitutionsl 29:338-367, 1949. 10. Stenstedt A: A study in manic-depressive psychosis, clinical, social, and genetic investigations . Acta Psychiatr Scand , (suppl 79) , 1952, pp 1-11. 11. Avery DH, Winokur G: Mortality in depressed patients treated with electroconvulsive therapy and antidepressants . Arch Gen Psychiatry 33:1029-1037, 1976.Crossref 12. Avery DH, Winokur G: The efficacy of electroconvulsive therapy and antidepressants in depression . Biol Psychiatry 12:507-523, 1977. 13. Pokorny AD: Suicide rates in various psychiatric disorders . J Nerv Ment Dis 139:499-506, 1964.Crossref 14. Ziskind E, Somerfeld-Ziskind E, Ziskind L: Metrazol and electroconvulsive therapy of the affective psychoses . Arch Neurol Psychiatry 53:212-217, 1945.Crossref 15. Huston PE, Locher LM: Involutional psychosis: Course when untreated and when treated with electric shock . Arch Neurol Psychiatry 59:385-394, 1948.Crossref 16. Huston PE, Locher LM: Manic-depressive psychosis: Course when treated and untreated with electric shock . Arch Neurol Psychiatry 60:37-48, 1948.Crossref 17. DeCarolis V, Giberti F, Roccatagliata G, et al: Imipramine and electroshock in the treatment of depression: A clinical statistical analysis of 437 cases . Sist Nerv 16:29-42, 1964. 18. Greenblatt M, Grosser GH, Wechsler H: Differential response of hospitalized depressed patients to somatic therapy . Am J Psychiatry 120:935-943, 1964. 19. Hordern A, Burt CG, Holt NF: Depressive States . Springfield, Ill, Charles C Thomas Publisher, 1965. 20. Bratfos 0, Haug JO: Electroconvulsive therapy and antidepressant drugs in manic-depressive disease, treatment results at discharge and three months later . Acta Psychiatr Scand 41:588-596, 1965.Crossref 21. Clinical trial of the treatment of depressive illness, Medical Research Council . Br Med J 1:881-886, 1965.Crossref 22. Angst J, Varga E, Shepherd M: Preliminary report of a retrospective study of the treatments of depression. Excerpta Medica International Congress Series No. 129, 1967. Proceedings of the Fifth International Congress of the Collegium Internationale Neuropsychopharmacologium, Washington, 28-31, March 1966. 23. Hutchinson JT, Smedberg D: Treatment of depression: A comparative study of ECT and six drugs . Br J Psychiatry 109:536-538, 1963.Crossref 24. Lönnqvist J, Niskanen P, Rinta-Mänty R, et al: Suicides in psychiatric hospitals in different therapeutic eras: A review of literature and own study . Psychiatr Fenn pp 265-273, 1974. 25. Hessø R, Retterstøl NT: Nor Laegeforen 95:1571, 1975. 26. Krieger G: Suicides, drugs and the open hospital . Hosp Commun Psychiatry , (July) 1966, pp 196-199. 27. Hussar AE: Effect of tranquilizers on medical morbidity and mortality in a mental hospital . JAMA 179:682-686, 1962.Crossref 28. Beisser AR, Blanchette J: A study of suicides in a mental hospital . Dis Nerv Syst 22:365-369, 1961. 29. Barraclough BM, Pallis DJ: Depression followed by suicide: A comparison of depressed suicides with living depressives . Psychol Med 5:55-61, 1975.Crossref 30. Simpson GM, Lee HL, Cuculic Z, et al: Two doses of imipramine in hospitalized endogenous and neurotic depressions . Arch Gen Psychiatry 33:1093-1102, 1976.Crossref 31. Burrows GD, Maguire KP, Scoggins BA, et al: Plasma nortriptyline and clinical response— study using changing plasma levels . Psychol Med 7:87-91, 1977.Crossref 32. Ziegler VE, Clayton PJ, Biggs JT: A comparison study of amitriptyline and nortriptyline with plasma levels . Arch Gen Psychiatry 34:607-612, 1977.Crossref 33. Segal BE, Humphrey J: A comparison of suicide victims and suicide attempters in New Hampshire . Dis Nerv Syst 31:830-838, 1970. 34. Schmidt E, O'Neal P, Robins E: Evaluation of suicide attempts as a guide to therapy . JAMA 155:549-557, 1954.Crossref 35. Motto JA: Suicide attempts, a longitudinal view . Arch Gen Psychiatry 13:516-520, 1965.Crossref 36. Batchelor IRC, Napier MD: The sequelae and short-term prognosis of attempted suicide: The results of a one-year follow-up of 200 cases . J Neurol Neurosurg Psychiatry 17:261-266, 1954.Crossref 37. Jansson B: A catamnestic study of 476 attempted suicide with special regard to the prognosis for cases of drug automatism . Acta Psychiatr Scand 38:183-198, 1962.Crossref 38. Guze SB, Robins E: Suicide and primary affective disorders . Br J Psychiatry 117:437-438, 1970.Crossref 39. Kessel N, McCullock W, Simpson E: Psychiatric service in a centre for the treatment of poisoning . Br Med J 2:985-988, 1963.Crossref 40. Rosen DH: The serious suicide attempt: Epidemiological and followup study of the patients . Am J Psychiatry 127:764-770, 1970. 41. Bratfos O: Attempted suicide . Acta Psychiatr Scand 47:38-56, 1971.Crossref 42. Murphy GE: Clinical identification of suicidal risk . Arch Gen Psychiatry 27:356-359, 1972.Crossref 43. Kennedy P, Kreitman N, Ovenstone MK: The prevalence of suicide and parasuicide ("attempted suicide") in Edinburgh . Br J Psychiatry 124:36-41, 1974.Crossref 44. Kraft DP, Babigian HM: Suicide by persons with and without psychiatric contacts . Arch Gen Psychiatry 33:209-215, 1976.Crossref 45. Dorpat TL, Ripley HS: A study of suicide in the Seattle area . Compr Psychiatry 1:349-359, 1960.Crossref 46. Robins E, Gassner S, Kayes J, et al: The communication of suicidal intent: A study of 134 consecutive cases of successful (completed) suicide . Am J Psychiatry 115:724-733, 1959. 47. Rosen A: Detection of suicidal patients: An example of some limitations in the prediction of infrequent events . J Consult Clin Psychol 18:397-403, 1954.Crossref 48. Juel-Nielsen N, Bille M, Flygenring J, et al: Frequency of depressive states within geographically delimited population groups-incidence (the Aarhus County investigation) . Acta Psychiatr Scand 37( (suppl 162) ):69-80, 1961.Crossref 49. Pederson AM, Barry DJ, Babigian HM: Epidemilogical considerations of psychotic depression . Arch Gen Psychiatry 27:193-197, 1972.Crossref 50. Silverman D: The epidemiology of depression-a review . Am J Psychiatry 124:883-891, 1968. 51. Weissman MM: The epidemiology of suicide attempts, 1960 to 1971 . Arch Gen Psychiatry 30:737-746, 1974.Crossref 52. Salzman L: An evaluation of shock therapy . Am J Psychiatry 103:669-679, 1947. 53. Oltman JE, Friedman S: Analysis of temporal factors in manicdepressive psychosis, with particular reference to the effect of shock therapy . Am J Psychiatry 107:57-68, 1950. 54. Bratfos O, Haug JO: The course of manic-depressive psychosis . Acta Psychiatr Scand 44:89-112, 1968.Crossref 55. Angst J, Baastrup P, Grof P, et al: The course of monopolar depression and bipolar psychoses . Psychiatr Neurol Neurochir 76:489-500, 1973. 56. DeCarolis V, Gibert F, Roccatagliata G, et al: Rilievi catamnestici della terapia imipraminica ed eletroconvulsivante delle depressioni . Sist Nerv 1:43-52, 1964. 57. Seager CP, Bird RL: Imipramine with electrical treatment in depression-a controlled trial . J Ment Sci 108:704-707, 1962. 58. Kay DWK, Fahy T, Garside RF: A seven-month double-blind trial of amitriptyline and diazepam in ECT-treated depressed patients . Br J Psychiatry 117:667-671, 1970.Crossref 59. Mindham RHS, Howland C, Shepherd M: An evaluation of continuation therapy with tricyclic antidepressants in depressive illness . Psychol Med 3:5-17, 1973.Crossref 60. Klerman GL, DiMascio A, Weissman M, et al: Treatment of depression by drugs and psychotherapy . Am J Psychiatry 131:186-191, 1974. 61. Paykel E, DiMascio A, Haskell D, et al: Effects of maintenance amitriptyline and psychotherapy on symptoms of depression . Psychol Med 5:67-77, 1975.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Jun 1, 1978

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