History of suicide attempts among patients with depression in the GENDEP project

Abstract Background It has been proposed that a history of suicide attempts could be a correlate of severe depressive disorder and that suicide attempters (SA) could represent a particular subtype of subjects suffering from major depressive disorder. We investigated clinical and demographic characteristics associated with SA and tested the hypothesis that a history of suicide attempts predicts poor response to antidepressants. Methods One-hundred-and-forty-one SA and 670 non-SA subjects with major depressive disorder (MDD) were treated for twelve weeks with escitalopram or nortriptyline in GENDEP, a part-randomized multi-center clinical and pharmacogenetic study. Baseline characteristics were compared using linear and logistic regression. Linear mixed models were used to analyse continuous outcomes during the twelve weeks of follow-up. Results At baseline, SA subjects suffered from more severe depression (mean Montgomery-Asberg Depression Rating Scale : 30.29 (7.61) vs 28.43 (6.54), p  = 0.0002), reported higher level of suicidal ideation (1.21 (0.82) vs 0.73 (0.48), p Limitations Due to its retrospective design, it is possible that more severely depressed subjects might report more suicide attempts than less depressed individuals. Conclusions While SA differed from non-SA in several clinical and demographic characteristics, the antidepressants were similarly effective in SA as in comparably severely depressed subjects without a history of suicide attempts.