Depressed people seem to have a few tell-tales on how close they are to becoming suicidal, according to a study conducted by the Hospital Clinic de Barcelona, in Spain.
Proneness to indulging in risky behaviors – atypical promiscuity or reckless driving – or inclination towards nervous habits, such as pacing or constant hand-wringing or pacing, could be pointing to an underlying problem: severe depression.
Researchers led by study author Dr. Dina Popovic discovered that acting impulsively with no regard to consequences could also represent a warning sign. Scheduled to be presented at the ECNP’s annual meeting in Amsterdam, the study concluded that depressed people exhibiting any of these symptoms might be at least 50 percent more likely to attempt suicide.
Dr Donald Malone, head of psychiatry and psychology at the Cleveland Clinic, is one of the US experts who concurred with the findings. He said that depressed patients who struggle with anxiety are not only more likely to commit suicide, but might also be diagnosed with bipolar depression (manic depressive disorder).
Popovic’s research team has evaluated over 2,800 people with depression, 630 of whom had attempted suicide. The study’s goal was to find differences in behavior between those who had attempted suicide and those who hadn’t by conducting individual in-depth interviews.
Researchers noticed that “depressive mixed states” were often reported before suicide attempts, a state where the depressed patient also experiences mania or excitation. Roughly 40 percent of the people with a history of attempted suicides had these episodes as well, compared with almost none of the mildly depressed people.
Using the standard criteria for diagnosing depression, researchers identified only 12 percent of patients with mixed depression. In contrast, with the new criteria they implemented, they were able spot 40 percent of these patients, meaning that patients at high risk of suicide escape through the cracks of diagnosis more often than not.
However, even if “mixed states” are not a symptom, bipolar patients will present a higher risk of suicide in general; according to Malone, psychiatrists should be careful with prescribing antidepressants, because they can worsen the situation with bipolar patients.
Not part of the study, Dr. Patrice Reives-Bright, chair of Child and Adolescent Services at South Oaks Hospital in Amityville, New York, agrees that the behaviors included by Dr. Popovic could improve the way we reach out to depressed people.
Besides the regular risk factors for suicide – hopelessness, not finding joy in anything, and recent loss – it’s important for doctors to be on the lookout with impulsive and risky behaviors as well.
With the World Health Organization reporting that over 800,000 people worldwide die by suicide every year, every new insight into the world of dealing with depression can help physicians to prevent the loss of additional lives.
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